Credentialing Specialist

Job Summary

To support a remote team, the full-time Credentialing Specialist will manage provider relationships, oversee credentialing processes, and resolve complex credentialing issues while ensuring compliance with state regulations.

Key responsibilities

• Develop and maintain relationships with providers and partners to facilitate credentialing requirements
• Track and manage credentialing files, ensuring timely completion and compliance with regulatory standards
• Research and resolve credentialing issues, coordinating with internal and external partners as necessary

Required qualifications

• Bachelor's Degree in a related field or 4 years of relevant functional experience
• Experience working directly with providers on credentialing policies and procedures
• Demonstrated ability to handle escalated issues with professionalism and leadership
• Strong analytical and investigative skills for evaluating provider information
• Proven ability to balance provider needs with corporate objectives