Credentialing Representative

Job Summary

A company is looking for a Credentialing Representative - National Remote.

Key Responsibilities

• Process provider applications and re-credentialing, including initial mailing and database tracking
• Conduct audits and provide feedback to improve processes and performance
• Act as a technical resource and demonstrate expertise in credentialing functions

Required Qualifications

• High School Diploma/GED (or higher)
• 6+ months of healthcare provider credentialing experience
• 6+ months of experience with compliance workflows and NCQA policies
• 6+ months of experience researching government regulatory information
• Intermediate proficiency with MS Excel and Word