Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist responsible for managing the credentialing processes for healthcare providers.

Key Responsibilities

• Ensure timely processing of Primary Source Verification for initial and recredentialing
• Align with NCQA, CMS, and state requirements related to provider credentialing
• Maintain up-to-date data for each provider in credentialing databases and ensure timely renewal of licenses and certifications

Required Qualifications

• 1+ years of experience in managed care credentialing and Primary Source Verification
• Ability to function independently and manage multiple projects
• Compliance with HIPAA rules and regulations
• Experience in handling sensitive and confidential information
• Ability to interpret guidelines from applicable regulatory bodies