Credentialing Specialist

A company is looking for a Credentialing Specialist to manage provider credentialing processes and ensure compliance with regulatory standards.

Key Responsibilities

Develop relationships with providers to gather necessary regulatory information for credentialing

Oversee and manage credentialing files, ensuring timely completion and compliance with state regulations

Research and resolve complex credentialing issues, coordinating with internal and external partners as needed

Required Qualifications

Bachelor's Degree in a related field or 4 years of functional experience in lieu of a degree

Experience in handling escalated issues and resolving conflicts professionally

Experience working with providers on credentialing policies and procedures

Ability to exercise discretion and independent judgment in job duties

Proven ability to balance provider needs with corporate objectives