Credentialing Assistant

The CORE Institute; Phoenix (AZ); On-site; USD 35,000 - 50,000; Full time

Job summary

The CORE Institute in Phoenix is seeking a Credentialing Assistant responsible for reviewing payer credentialing statuses and maintaining provider profiles. The ideal candidate has 3-4 years of experience in healthcare and effective communication skills to work with physicians and insurance agencies. A high school diploma or GED is preferred. Join our team and contribute to credentialing accuracy and efficiency in a supportive environment.

Qualifications

• Must be able to communicate effectively with various stakeholders.
• Minimum of three to four years of experience in healthcare.
• Some knowledge of insurance billing and credentialing processes is a plus.

Responsibilities

• Review and update provider's CAQH profiles and statuses.
• Maintain current insurance grids and physician spreadsheets.
• Assist Credentialing Supervisor and Credentialing Specialist in duties.

Skills

Effective communication with physicians

Knowledge of insurance billing

Understanding of the credentialing process

Experience in healthcare

Education

High school diploma/GED

Job description

Qualifications & Requirements

• Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors, and the public and be capable of establishing good working relationships with both internal and external customers.
• Some knowledge of insurance billing and hospital credentialing is a plus.
• Knowledge of the credentialing process is a plus but not required.
• Knowledge of credentialing timelines and regulations is a plus but not required.
• Minimum of three to four years of experience in healthcare.
• High school diploma/GED or equivalent working knowledge preferred.

Essential Functions

• Reviews and Re‑Attest all provider's CAQH profiles.
• Maintain billing insurance grid, provider insurance grid, and each physician’s spreadsheet up to date on current insurance changes.
• Has knowledge of Employee Handbook content along with established policies and procedures.
• Relies on instructions and pre‑established guidelines to perform the functions of the job.
• Assists the Credentialing Supervisor and Credentialing Specialist in their job responsibilities/duties when necessary.

Credentialing Assistant is responsible for reviewing the Payer Credentialing status for all new providers, maintaining all rosters, updating CAQH provider profiles, and more.

Equal Opportunity Employer. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.