Credentialing Specialist

Job Summary

To support health plan operations, the remote Credentialing Specialist will verify provider credentials, track applications, and maintain accurate provider information while ensuring compliance with regulations.

Key responsibilities

• Verify provider credentials through approved sources in a timely and accurate manner
• Track and process credentialing and re-credentialing applications
• Communicate with providers or their office staff regarding credentialing status and required documentation

Required qualifications

• 1+ years of experience in provider credentialing for a health plan
• Familiarity with NCQA, CMS, and state credentialing standards
• Strong organizational and time management skills
• Able to work independently and in a team setting
• Ability to meet deadlines and handle high-volume work