Credentialing Representative

Job Summary

A company is looking for a Credentialing Representative who will manage credentialing and re-credentialing activities for healthcare providers.

Key Responsibilities:

• Process providers and re-credentialing requests, including initial communications, verifications, review, and database entry
• Conduct quality audits and provide feedback to enhance processes and reduce errors
• Ensure compliance with NCQA, CMS, State, and Federal credentialing requirements

Required Qualifications:

• High School Diploma/GED (or higher)
• 1+ years of healthcare customer service and/or administration experience
• Intermediate proficiency with Microsoft Excel and Microsoft Word