Key Facts

Remote From:

Full time

English

Hard Skills

Enrollment Management Credential Manager Academic Support Services Digital File Management Collaborative Software Time Tracking Software Provider Data Management Benefits Administration Microsoft SharePoint Credential Manager Online Communication

Other Skills

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Microsoft Excel
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Non-Verbal Communication
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Multitasking
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Time Management
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Teamwork
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Organizational Skills
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Detail Oriented

Roles & Responsibilities

At least 1 year of experience in credentialing, provider enrollment, or healthcare administration
Strong attention to detail and excellent organizational skills
Proficiency in Microsoft Excel and document management systems
Familiarity with credentialing software (e.g., Verity CredentialStream) is a plus

Requirements:

Assist in completing and submitting provider enrollment applications; track outstanding applications and follow up with health plans and provider relations to ensure timely enrollment
Create and maintain electronic credential files and provider data sheets; keep credentialing records accurate and up to date
Maintain CAQH re-attestation tracking and ensure HIPAA-compliant credentialing activities
Document daily activities in Verity CredentialStream, SharePoint, and other systems; manage Excel tracking sheets and provide updates to internal stakeholders

Job description

The Credentialing Assistant provides administrative and operational support to the Credentialing and Provider Enrollment team for Resolv Hospital clients. This role is responsible for maintaining accurate provider records, managing credentialing documentation, coordinating enrollment processes, and ensuring compliance with HIPAA regulations.

The ideal candidate is detail-oriented, organized, and comfortable working with credentialing software, Excel tracking sheets, and external health plan representatives.

Key Responsibilities

Provider Enrollment & Credentialing Support

Assist in completing and submitting provider enrollment applications
Track outstanding applications and follow up with health plans and provider relations representatives to ensure timely enrollment completion
Support new practice setup as needed
Submit change-of-information letters and W-9 forms for practice updates (e.g., new locations, address changes, remit updates)

Provider Records & Documentation Management

Create and maintain electronic credential files according to Global Share Filing Structure Policy
Maintain and update provider data sheets and credential spreadsheets
Ensure provider records in credentialing software databases remain accurate and up to date
Maintain organized and current electronic credential files
Set reminders in Verity CredentialStream for credential expiration dates
Update documentation such as medical licenses, DEA registrations, COIs, and other required credentials

CAQH & Compliance Management

Maintain CAQH re-attestation tracking and complete required re-attestations
Ensure all credentialing activities comply with HIPAA guidelines and safeguard protected health information (PHI)

Communication & Follow-Up

Respond to incoming emails and faxes regarding credential renewals, W-9 requests, and related inquiries
Contact health plans and medical facilities to check the status of applications, contracts, or change requests
Provide updates and documentation to internal stakeholders as needed

Systems & Reporting

Document all daily activities in Verity CredentialStream, SharePoint, Teamwork, and Time Tracker
Maintain Excel tracking sheets for emergency and urgent care practices
Provide research and administrative support for special projects

Qualifications

At least 1 year experience in credentialing, provider enrollment, or healthcare administration preferred
Strong attention to detail and organizational skills
Proficiency in Microsoft Excel and document management systems
Familiarity with credentialing software (e.g., Verity CredentialStream) is a plus
Excellent written and verbal communication skills
Ability to manage multiple tasks and follow up consistently