Senior Credentialing Auditor

Job Summary

A company is looking for a Senior Credentialing Representative - Quality Auditor.

Key Responsibilities

• Perform daily audits of credentialing and recredentialing files using standardized templates
• Participate in audit result reviews, root cause analysis, and identify process improvement opportunities
• Collect and review credentialing files for submission to delegating health plans during audits

Required Qualifications

• High School Diploma/GED (or higher)
• 2+ years of experience in credentialing
• 1+ years of experience using credentialing software or managing provider information