Credentialing Specialist
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Job Summary
Performing credentialing and re-credentialing activities in compliance with NCQA standards, the full-time Credentialing Specialist will work remotely to gather information, communicate with healthcare providers, and maintain accurate credentialing records.
Key responsibilities
- Conduct credentialing and re-credentialing activities according to plan specifications
- Communicate professionally with physicians and other stakeholders to secure necessary information
- Process, track, and file credentialing applications while generating reports to support business functions
Required qualifications
- Associate's degree or high school diploma/equivalent with 1+ years of relevant experience
- Experience in data entry, customer service, medical office, or healthcare operations
- Ability to perform Primary Source Verification (PSV) for education verification
- Familiarity with managed care or insurance environments is preferred
Complete Job Description
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