Provider Credentialing Analyst

Job Summary

A company is looking for an Analyst I - Provider Credentialing - QC Analyst.

Key Responsibilities

• Verify and process primary source documentation for healthcare-related credentials
• Ensure compliance with NCQA, CMS, Medicaid, and Medicare regulatory standards
• Conduct audits and quality assurance related to credentialing compliance

Required Qualifications

• Bachelor's degree required
• 3+ years of related healthcare or health plan experience in credentialing compliance, auditing, and quality assurance
• 2+ years of experience with direct primary source documentation review
• Preferred experience with NCQA, CMS, Medicaid, and Medicare regulatory compliance standards
• MDStaff experience is preferred