Credentialing Specialist

Job Summary

To ensure all affiliated physicians and providers meet healthcare service qualifications, the full-time Credentialing Specialist will manage credentialing information, verify necessary documentation, and prepare files for review, all while working remotely.

Key responsibilities

• Maintain and process credentialing information for health plan practitioners in accordance with policies and regulatory requirements
• Verify licenses and certifications through various sources and retrieve missing documentation as needed
• Prepare credentialing files for review by Medical Directors and assist with broader issues requiring further action

Required qualifications

• High school diploma required; Bachelor's degree preferred
• 1-2 years of experience in the healthcare field required; experience with provider credentialing preferred
• Proficiency in using a credentialing information system and Microsoft Word and Excel
• Ability to prioritize multiple tasks and work under time-sensitive conditions
• Strong organizational skills and initiative, with a keen attention to detail