Job Description
**Role Overview**
The Credentialing Specialist is responsible for managing credentialing and re-credentialing processes for all providers in compliance with NCQA, state, and federal regulations.
**Key Responsibilities**
+ Validate completeness of provider applications prior to processing.
+ Perform primary source verification for credentialing and re-credentialing applications.
+ Monitor site visit progress and ensure completion within established timeframes.
+ Accurately enter provider application data into the credentialing system.
+ Respond to inquiries from internal and external clients via the credentialing phone queue.
+ Complete assigned projects and tasks within deadlines.
**Education & Experience**
+ High School Diploma or GED and 4+ years of credentialing experience
+ OR Associate’s degree with 1–2 years of credentialing experience
+ Bachelor’s degree preferred with at least 1 year of credentialing or related experie...
The Credentialing Specialist is responsible for managing credentialing and re-credentialing processes for all providers in compliance with NCQA, state, and federal regulations.
**Key Responsibilities**
+ Validate completeness of provider applications prior to processing.
+ Perform primary source verification for credentialing and re-credentialing applications.
+ Monitor site visit progress and ensure completion within established timeframes.
+ Accurately enter provider application data into the credentialing system.
+ Respond to inquiries from internal and external clients via the credentialing phone queue.
+ Complete assigned projects and tasks within deadlines.
**Education & Experience**
+ High School Diploma or GED and 4+ years of credentialing experience
+ OR Associate’s degree with 1–2 years of credentialing experience
+ Bachelor’s degree preferred with at least 1 year of credentialing or related experie...
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