Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist I to perform credentialing and related activities based on plan specifications.

Key Responsibilities

• Perform credentialing and re-credentialing activities in compliance with NCQA standards
• Communicate professionally with physicians, office managers, and providers to secure necessary information
• Process, track, and file credentialing applications while generating reports to support business functions

Required Qualifications

• Associate's degree or high school diploma/equivalent with 1+ years of relevant experience
• Experience in data entry, customer service, medical office, or healthcare operations
• Preferably experience in a managed care or insurance environment
• Ability to thrive in a fast-paced production environment