Credentialing Support Associate III

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

📋 Description

• Ensure the integrity of provider information by entering, updating, and auditing data within credentialing systems.

• Oversee recredentialing processes, including disseminating recredentialing communications and tracking provider responses.

• Engage with providers to gather missing documentation, address discrepancies, and guarantee comprehensive credentialing files.

• Perform primary source verification tasks for initial credentialing and recredentialing applications in line with regulatory standards and company policies.

• Monitor and follow up on outstanding credentialing requirements to ensure timely processing and compliance.

• Collaborate with internal stakeholders to maintain accurate, complete, and compliant provider records in accordance with organizational policies.

• Contribute to ongoing improvement initiatives aimed at enhancing credentialing processes and data quality.

• Report directly to the Credentialing leadership team.

⛳️ Requirements

• High school diploma or equivalent qualification.

• Proven experience in provider credentialing, healthcare operations, provider enrollment, or administrative functions.

• Familiarity with maintaining and updating data in databases or business systems.

• Exceptional attention to detail and a strong commitment to data accuracy.

• Excellent verbal and written communication abilities.

• Capability to adhere to established processes and regulatory guidelines.

• Strong organizational and time management skills.

• Ability to juggle multiple priorities in a fast-paced, deadline-driven environment.

• Proficient in Microsoft Office applications, including Excel and Outlook.

• Preferred experience in provider credentialing and recredentialing processes.

• Knowledge of NCQA, CMS, state, or other healthcare regulatory requirements is preferred.

• Prior experience in conducting primary source verification activities is preferred.

• Experience with credentialing software or provider management systems is preferred.

• Understanding of healthcare provider networks and credentialing standards is preferred.

• Must possess legal authorization to work in the United States without employer sponsorship/support now or at any time in the future.

🏝️ Benefits

• Support and flexibility to help achieve both professional and personal goals.

• Opportunities for skill development.

• Leadership development initiatives.

• Philanthropic engagement opportunities.

• Comprehensive, supportive, flexible, and inclusive benefits and resources.

• Benefits available for full-time eligible employees.