Credentialing Specialist

Overview

Why consider this job opportunity:

• Competitive salary with the opportunity to participate in the company's bonus program
• Comprehensive medical, dental, vision, and life insurance coverage
• Flexible paid leave and vacation policy
• 401(k) plan with matching contributions
• Opportunity to work in a dynamic and innovative care management company focused on transforming healthcare delivery
• Chance to make a significant impact on patient care for individuals with chronic conditions

What to Expect (Job Responsibilities)

• Review and process internal credentialing applications for healthcare providers, ensuring accuracy and completeness of information
• Maintain detailed and up-to-date provider credentialing and verification records in compliance with regulatory standards
• Communicate clearly with providers and healthcare leadership regarding credentialing issues and timelines
• Verify provider credentials including licenses, certifications, and work history through various methods
• Support management with administrative components of credentialing committees, including meeting coordination and documentation

What is Required (Qualifications)

• Bachelor's degree preferred
• 3-5 years of experience in credentialing or a related field required
• Proficiency in Microsoft Office applications (e.g., Word, Excel, PowerPoint)
• Knowledge of Medicaid and/or Medicare credentialing requirements
• Excellent verbal and written communication skills

How to Stand Out (Preferred Qualifications)

• Familiarity with NCQA accreditation credentialing survey requirements
• Ability to research data and draw conclusions effectively
• Experience in a credentialing department or medical staff office
• Strong organizational skills and ability to manage multiple time-sensitive deliverables
• Investigative and detail-oriented mindset

We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.

We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.

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