Senior Credentialing Representative

Job Summary

A company is looking for a Senior Credentialing Representative to support provider credentialing processes remotely.

Key Responsibilities:

• Process provider applications and maintain tracking systems
• Conduct audits and provide feedback to enhance processes and reduce errors
• Act as a technical resource and facilitate conflict resolution within the team

Required Qualifications:

• High School Diploma/GED or 5+ years of provider credentialing experience
• 4+ years of healthcare provider enrollment/credentialing experience
• 2+ years of experience with compliance workflows, including NCQA policies
• 2+ years of experience with Medicare and state Medicaid systems in specified states
• Intermediate proficiency with MS Excel and Word, and computer systems