Senior Credentialing Representative

Job Summary

Working remotely on a full-time basis, the Senior Credentialing Representative will manage the processing of provider applications and re-applications, conduct audits to enhance performance, and serve as a technical resource within the credentialing team.

Key responsibilities:

• Process provider applications and re-applications, ensuring accurate data entry into the database tracking system
• Conduct audits and provide feedback to improve processes and reduce errors
• Act as a mentor and resource for team members, facilitating conflict resolution and coordinating activities

Required qualifications:

• High School Diploma/GED
• 2+ years of health care provider credentialing experience
• 2+ years of experience with compliance workflows and NCQA policies
• Intermediate proficiency in MS Excel and Word