Credentialing Specialist I

What are important things that YOU need to know about this role?

• Hours are flexible during the week, Monday through Friday

• This position is open to permanently remote candidates

• Candidates must have strong attention to detail and claim accuracy

What will YOU be doing for us?  Ensures organization meets all necessary requirements in credentialing and re-credentialing medical, dental, therapy, and vision providers according to client and NCQA guidelines.

What will YOU be working on every day?

• Verify provider credentials according to product and quality guidelines for provider acquisition and re-credentialing.

• Prepare provider files for review.

• Ensure accuracy of provider information in credentialing systems by matching provider entered data with all credentialing documents.

• Recommend system enhancements and process improvements.  

• Respond to provider inquiries related to the credentialing process

• Perform outreach to providers to obtain completed credentialing applications.

• Must comply with registering and creating your own id.me account or using your personal id.me account in which you have completed identity verification (uploading a copy of government issued id, SSN and picture or video scan) to access NPDB.

What qualifications do YOU need to have to be GOOD candidate?

• Required Level of Education, Licenses, and/or Certificates

  • High school diploma/GED

• Required Level of Experience

  • 1+ years of experience in an office setting

• Required Knowledge, Skills, and Abilities

  • Demonstrate knowledge of Microsoft products including Word, Excel, and email

  • Strong typing skills

  • Ability to remain organized and meet multiple conflicting deadlines

  • Attention to detail

  • Strong outreach phone skills

What qualifications do YOU need to have to be a GREAT candidate?

• Preferred Level of Education, License, and/or Certificates

  • Associates/2 year degree

• Preferred Level of Experience

  • 1-3 years of experience in a healthcare environment.

  • Provider Relations or Credentialing experience preferred.

The salary range and midpoint is listed below for your reference. Please keep in mind that your education and experience along with your knowledge, skills and abilities are taken into consideration when determining placement within the range.

Compensation Range:

Compensation Midpoint: