Credentialing Specialist

The Elevance Health Companies, Inc.; Boght Corners (NY); Hybrid; USD 28,000 - 43,000; Full time

Benefits offered by this job

Health insurance

401(k) contribution

Job summary

Elevance Health, Inc. is hiring a Credentialing Specialist in New York for a hybrid role requiring in-office presence 1–2 days per week. The position supports provider credentialing processes, file preparation for committees, and documentation accuracy across diverse provider applications.

You will review applications, request missing information, and resolve discrepancies while coordinating with providers and senior staff. A high school diploma and credentialing experience are expected.

Qualifications

• Requires at least 1 year credentialing or related experience.
• Credentialing/practitioner and facility credentialing preferred.

Responsibilities

• Receives provider applications and contacts providers for any additional supporting documentation or clarification.
• Builds file documentation and prepares file for credentialing committee review.
• Applies general guidelines in determining whether provider meets criteria and documents deficiencies.
• Prepares correspondence to providers regarding status.
• Assists in researching pended and probated applications and resolving discrepancies.
• Refers non-approved providers or questionable situations to senior representative.
• May assist in provider education and preparation of provider training materials.

Skills

Credentialing

Documentation

Education

High school diploma or equivalent

Job description

Credentialing Specialist

Anticipated End Date: 2026-11-17

Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

How you will make an impact

• Receives provider applications and contacts providers for any additional supporting documentation or clarification.
• Builds file documentation and prepares file for credentialing committee review.
• Applies general guidelines in determining whether provider meets criteria and documents deficiencies.
• Prepares correspondence to providers regarding status.
• Assists in researching pended and probated applications and resolving discrepancies.
• Refers non-approved providers or questionable situations to senior representative.
• May assist in provider education and preparation of provider training materials.

Minimum Requirements

• Requires high school diploma or equivalent.
• Minimum of 1 years credentialing or related experience.
• Or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences

• Practitioner and facility credentialing strongly preferred.

Location(s): New York

For this specific position, the salary range is $20.60 to $30.90.

Benefits

• Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.

Elevance Health will also follow all relevant federal, state and local laws.

Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Elevance Health is an Equal Opportunity Employer/Disability/Veterans.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

Join our Talent Community and stay connected with company news, information, and future job opportunities.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration. Please visit the Contract Worker Community Page. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Elevance Health is an Equal Opportunity Employer/Disability/Veterans.

Job Level: Non-Management Non-Exempt

Workshift: Job Family: PND > Credentialing & Licensing