Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist to ensure healthcare providers meet compliance and regulatory requirements.

Key Responsibilities

• Collect, review, and process initial and re-credentialing applications from healthcare providers
• Ensure compliance with NCQA standards and maintain accurate provider data in tracking systems
• Facilitate communication with providers and support credentialing audits and quality assurance initiatives

Required Qualifications

• Associate's degree or 3+ years of experience in healthcare credentialing, insurance, or provider network operations
• Knowledge of NCQA guidelines and health plan credentialing processes
• Proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook)
• 4 years of relevant experience preferred
• Experience level: Experienced