Job Description
Pay: $20.00 - $30.00 per hour
Job description:
Credentialing Specialist
Pay: Up to $30/hr, depending on experience.
Location: Remote (must be in the Eastern Time Zone; no NY or CA).
Schedule: M-F, 40 hours/week, 9 AM EST start time.
Are you an experienced Credentialing Specialist ready for a new challenge? Our client is looking for a highly skilled professional to join our team in a temp-to-perm, remote role.
This is a fast-paced, high-volume environment, so we need someone who can hit the ground running. You'll be the point person for all things credentialing, from initial applications to re-credentialing cycles and compliance audits. If you're detail-oriented, have a knack for process improvement, and know your way around CMS, MD Staff, Adobe Pro, and Excel , we want to hear from you.
What You'll Do:
Manage the credentialing process from start to finish, ensuring all applications are complete and accurate.
Keep our provider database up-to-date and compliant.
Serve as a key resource for our CVO and PHSO teams.
Help prepare for NCQA audits and make sure we're always following the rules.
Work with providers to gather documentation and keep them informed.
Assist with committee meetings, reports, and follow-up activities.
What You'll Need: At least 3 years of experience in a health insurance or healthcare setting.
5+ years of professional secretarial, administrative, or credentialing experience.
Hands-on experience with CMS, MD Staff, Adobe Pro, and Excel.
In-depth knowledge of NCQA guidelines.
Exceptional organizational skills and an eagle eye for detail.
A proven ability to communicate effectively and solve problems independently.
Bonus Points: An Associate's or Bachelor's degree in a related field.
NCQA & NAM certifications. Professional Staffing Services Group
Job Tags
Hourly pay, Permanent employment, Temporary work,
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