California Licensed Credentialing Representative

Job Summary

A company is looking for a Senior Credentialing Representative.

Key Responsibilities

• Manage initial and re-credentialing submissions for commercial and government payers
• Independently verify provider board certifications, licensures, and DEA registrations
• Monitor expirations and process renewals for all necessary credentials

Required Qualifications

• Proficient in Microsoft Office and credentialing platforms like Symplr Payer and CAQH
• Understanding of California-specific regulations, including CMS and Medi-Cal requirements
• Experience in maintaining provider data in relevant systems
• Ability to ensure compliance with regulatory standards
• Experience coordinating with various stakeholders to resolve credentialing issues