Credentialing Specialist

Position Summary

Reviews analyzes, evaluates, validates provider/producer information against business/credentialing requirements and maintains information on Credentialing databases. Supports extensive research and analysis of sensitive provider/producer issues; addresses data integrity issues.

• Assist with reviewing, analyzing, and validating provider/producer information to ensure it meets credentialing and business requirements
• Maintain and update provider/producer records in credentialing databases with a high level of accuracy
• Support research and review of provider/producer information, escalating sensitive or complex issues as needed
• Help identify and correct data discrepancies to support overall data integrity and compliance
• Handle confidential and sensitive information with professionalism, discretion, and care
• Organize and prioritize assigned tasks to meet deadlines in a fast-paced environment
• Draft and respond to basic professional correspondence, including emails and routine notices
• Communicate effectively with providers, internal staff, and management under guidance and supervision
• Work independently on routine tasks while seeking guidance for new or complex issues
• Use Microsoft Office applications (Word, Excel, Access) and internet resources to research and maintain information
• Demonstrate strong attention to detail and willingness to learn credentialing policies, procedures, and systems

• 1+ years customer service experience.
• 6+ months experience researching and analyzing data.
• 6+ months experience working with Microsoft Office applications (Word, Excel, Access) and internet resources.
• Ability to work reliably, prudently, and tactfully with confidential information.
• Ability to organize and prioritize work and manage multiple priorities.
• Excellent verbal and written communication skills including, letters, memos, and emails.

• Ability to work independently on routine tasks
• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
• College degree or equivalent work experience

High School Diploma/Associate's degree preferred

40

Full time

$17.00 - $28.46

Benefits include medical, dental, vision coverage, paid time off, retirement savings options, wellness programs, and other resources.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.