Credentialing Specialist 1 - 111453

Credentialing Specialist 1 - 111453

BC Forward is looking for Credentialing Specialist 1 (Remote) in Remote -Florida

Position Title : Credentialing Specialist 1 (Remote)

Locations : Remote -Florida

Anticipated Start Date : 10 / 13

Expected Duration : 6 Months

Job Type : Contract with possible extension and temp to hire

Shift : 8 : 00am - 4 : 30 pm

Pay Rate $28.00hr on W2.

Need : Associate's degree, or high school diploma / equivalent with 1+ years' experience in data entry, customer service, medical office, provider data management, credentialing, or healthcare operations.

Job Description :

Credentialing Specialist

Summary :

The Credentialing Specialist is responsible for credentialing individual, facility, and / or ancillary medical / surgical providers to ensure all credentialing standards and internal requirements are met and maintained.

Job Responsibilities :

• Verify and maintain all network, individual, facility, and ancillary provider information.
• Monitor disciplinary actions and follow up accordingly.
• Correspond with licensing boards, hospitals, certification agencies, training programs, and medical groups to resolve credentialing issues.
• Ensure and maintain overall accuracy of the credentialing database.
• Gather data, build / run reports, and send updates as required.
• Communicate with practitioners, office staff, provider network administrators, contracting, and management to resolve credentialing issues.
• Review and identify credentialing or re-credentialing practitioners, including verification of correspondence and data entry, in accordance with company policies and procedures.
• Review and analyze reports, policies, and procedures; summarize findings, make notations, and provide feedback for distribution to management and the Credentialing Committee.
• Assist in preparing file reports and binders for monthly Credentialing Committee meetings, including pre- and post-Committee functions.
• Support internal projects to obtain follow-up information as requested by the Credentialing Committee or Peer Review Teams.
• Perform other duties as assigned.

Education / Experience :

Centene Job Description

Position Purpose :

Perform credentialing and related activities in alignment with plan specifications.

Education / Experience :

Key Responsibilities :

Story Behind the Need - Business Group & Key Projects

The Credentialing Specialist will work within the Credentialing Triage Team. Responsibilities include reviewing requests submitted via online webforms, gathering required documentation, and submitting them through the internal system. Missing information will require outreach to providers via email. Strong time management is essential to balance new requests and pending follow-ups.

Typical Day in the Role

Compelling Story & Candidate Value Proposition

Candidate Requirements

Education / Certification :

Licensure :

Experience :

Must-Haves :

Nice-to-Haves :

Disqualifiers :

Performance Indicators :

Best vs. Average Candidates :

Benefits :

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

About BCforward :

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum . As part of the recruitment process, we may ask you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 244432 when responding to this ad.

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Job Snapshot

Employee Type Contractor

Location Florida, FL (Onsite)

Job Type Health Care

Experience Not Specified

Date Posted 09 / 24 / 2025