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 and communicate errors to the team
• Participate in audit result reviews, root cause analysis, and identify process improvement opportunities
• Collect and review credentialing files for submission to health plans during audits

Required Qualifications

• High School Diploma/GED (or higher)
• 2+ years of experience in credentialing
• 1+ years of proven consistent quality audit scores meeting or exceeding requirements
• 1+ years of experience using credentialing software or managing provider information