Credentialing Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Verify provider credentials through authorized sources in a timely and precise manner.

• Track and manage credentialing and re-credentialing applications.

• Input and update provider details in the credentialing database.

• Maintain and refresh provider demographic information.

• Oversee and administer data from delegated entities.

• Interact with providers or their office personnel regarding credentialing status and necessary documentation.

• Identify and report any non-compliance or credentialing concerns to the supervisor.

• Ensure the confidentiality of sensitive information and documents.

• Execute additional responsibilities as assigned.

⛳️ Requirements

• Minimum of 1 year of experience in provider credentialing for a health plan.

• Strong organizational and time management abilities.

• Capability to meet deadlines and manage high-volume tasks.

• Proficient in working both independently and collaboratively within a team.

• Excellent attention to detail and strong problem-solving capabilities.

• Familiarity with NCQA, CMS, and state credentialing regulations.

• Outstanding written, verbal, and interpersonal communication skills.

🏝️ Benefits

• Medical, Dental, and Vision coverage.

• Life Insurance.

• Short-Term and Long-Term Disability options.

• Flexible Spending Account (FSA).

• Employee Assistance Program.

• 401(k) with employer contribution.

• Paid Time Off (PTO).

• Tuition Reimbursement.