Provider Credentialing Specialist

Job Summary

A company is looking for a Provider Credentialing Specialist responsible for managing the credentialing processes for healthcare providers.

Key Responsibilities

• Ensure timely processing of Primary Source Verification for initial and recredentialing
• Resolve complex provider credentialing issues in alignment with NCQA, CMS, and state requirements
• Maintain up-to-date data for each provider and coordinate reporting under supervision

Required Qualifications

• 1+ years of experience in managed care credentialing and Primary Source Verification
• Ability to function independently and manage multiple projects
• Compliance with HIPAA rules and regulations
• Experience in communicating effectively with practitioners and internal stakeholders
• Strong organizational skills and attention to detail