Credentialing Operations Specialist

Transcarent; Poland; Remote; PLN 78,000 - 134,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401(k) with company match

Flexible Time Off

Life Insurance

Disability Insurance

Mental Health benefits

Job summary

Transcarent is seeking a Credentialing Coordinator to manage day-to-day credentialing and re-credentialing activities for our provider network. You will verify licensure, education, and credentials in line with NCQA standards and payer requirements.

You’ll collaborate with compliance, licensing, and network operations to ensure timely, accurate files and prepare for internal and external audits. This role emphasizes attention to detail and process efficiency within a fast-paced health care

Qualifications

• 3+ years of experience in provider credentialing, medical staff services, healthcare operations, or a related operational role.
• Working knowledge of NCQA credentialing standards and primary source verification requirements.
• Familiarity with provider licensure requirements across multiple states.

Responsibilities

• Execute day-to-day credentialing and re-credentialing work in support of our provider network, ensuring timely, accurate, and compliant completion of assigned deliverables.
• Process initial credentialing and re-credentialing applications by reviewing provider files against NCQA standards, payer requirements, and internal guidelines.
• Perform primary source verification, including licensure, board certification, education, work history, malpractice history, and sanctions checks.
• Execute supporting tasks related to delegated credentialing audits and payer credentialing submissions.
• Partner with credentialing team members to manage caseload, meet turnaround times, and maintain file quality.
• Collaborate with provider relations, licensing, compliance, and network operations partners to resolve questions, issues, escalations, and delays.
• Review provider data, applications, and supporting documentation to identify discrepancies or items requiring follow-up.
• Document findings clearly in the credentialing database and elevate non-standard situations when appropriate.
• Follow established policies, procedures, and workflows while maintaining a high level of detail and accuracy for audits.

Skills

Credentialing experience

NCQA knowledge

Analytical mindset

Multistate licensure

Detail-oriented

Team collaboration

Education

Bachelor’s degree in healthcare/business

Job description

Transcarent is seeking a Credentialing Coordinator to manage day-to-day credentialing and re-credentialing activities for our provider network. You will verify licensure, education, and credentials in line with NCQA standards and payer requirements.

You’ll collaborate with compliance, licensing, and network operations to ensure timely, accurate files and prepare for internal and external audits. This role emphasizes attention to detail and process efficiency within a fast-paced health care