Lead Credentialing Specialist

Job Summary

A company is looking for a Lead, National Credentialing.

Key Responsibilities

• Oversees day-to-day operations of the credentialing team, ensuring quality and compliance with turnaround times
• Prepares for and participates in credentialing audits and NCQA accreditations, developing necessary documentation and training materials
• Provides training and support to credentialing team members while monitoring vendor compliance and performance metrics

Required Qualifications

• At least 4 years of experience in provider credentialing or equivalent education and experience
• Knowledge of CMS, NCQA, and other credentialing-related regulations
• Data entry skills and production-related experience
• Self-direction and logical thinking abilities
• Ability to work collaboratively in a matrixed organization with various stakeholders