Credentialing Specialist

Job Summary

To support a growing Credentialing Verification Organization, the hybrid Credentialing Specialist will manage and verify credentialing applications for initial appointments and reappointments, ensuring compliance with regulatory standards while collaborating with internal staff and providers.

Key responsibilities

• Perform comprehensive management and verification of credentialing applications, including monitoring expiring provider documents
• Conduct preliminary analysis of application data to identify potential issues and communicate updates to providers
• Maintain accurate credentialing documentation and assist in improving credentialing workflows and processes

Required qualifications

• High school diploma or GED required
• 1-3 years of relevant credentialing experience, preferably within a CVO or similar setting
• Proficiency with Microsoft Office applications and web-based systems
• Knowledge of credentialing software platforms and auditing processes preferred
• Ability to interpret and apply credentialing standards and regulatory guidelines