Credentialing Specialist

Job Summary

To support the credentialing process remotely, the full-time Credentialing Specialist will develop relationships with providers, manage credentialing files, and ensure compliance with state regulations while resolving complex issues.

Key responsibilities

• Establish and maintain relationships with providers to gather necessary regulatory information for credentialing
• Track and manage credentialing files, ensuring timely completion and compliance with state standards
• Research and resolve credentialing issues, collaborating with internal and external partners as needed

Required qualifications

• Bachelor's Degree in a related field or 4 years of functional experience in lieu of a degree
• Experience working with providers on credentialing policies and procedures
• Demonstrated professionalism and leadership in conflict resolution and escalated issues
• Strong analytical and investigative skills for evaluating provider information
• Ability to work independently and collaboratively in a team environment