Credentialing Representative

Job Summary

A company is looking for a Credentialing Representative for a national remote position.

Key Responsibilities

• Process providers and re-credentialing, including initial communications, verifications, and database loading
• Conduct quality audits and provide feedback to reduce errors and improve processes
• Ensure adherence to credentialing policies and compliance with NCQA, CMS, and other regulatory requirements

Required Qualifications

• High School Diploma/GED or higher
• 1+ years of healthcare customer service and/or administration experience
• Intermediate proficiency with Microsoft Excel and Microsoft Word