Associate Specialist, Corporate Credentialing - Remote

Overview

This position is responsible for the initial credentialing, recredentialing, and ongoing monitoring of sanctions and exclusions for practitioners and health delivery organizations, ensuring compliance with regulatory and risk management criteria.

In Short

• Evaluate credentialing applications for accuracy and completeness.
• Communicate with healthcare providers for missing information.
• Update credentialing software systems.
• Request and follow up on recredentialing applications.
• Collaborate with internal and external contacts for timely processing.
• Complete data corrections in the credentialing database.
• Review claims payment systems to determine provider status.
• Process daily alerts for sanctions and exclusions.
• Review Medicare Opt-Out reports.
• Take action on NPDB Continuous Query reports.

Requirements

• High School Diploma or GED.
• Experience in a production or administrative role.
• Extensive computer skills, including Microsoft Outlook and Word.
• Professional written and verbal communication skills.
• Preferred: Experience in the healthcare industry.

Benefits

• Competitive benefits and compensation package.
• Equal Opportunity Employer.