Credentialing Specialist

Randstad USA; United States; Remote; USD 40,000 - 55,000; Full time

Job summary

Randstad USA is seeking a passionate Credentialing Specialist to manage physician enrollment and ensure compliance with regulatory standards. In this full-time role, you will work within a dynamic healthcare team, contributing to positive health outcomes while supported by friendly colleagues and management invested in your success.

Benefits

Medical insurance

Vision insurance

401(k)

Disability insurance

Qualifications

• 5+ years of credentialing or healthcare admin experience.
• Strong knowledge of NCQA guidelines and credentialing processes.

Responsibilities

• Manage high-volume physician enrollment with insurance payers.
• Collect, review, and submit credentialing applications.
• Support audits and compile credentialing committee materials.

Skills

Credentialing

Healthcare Administration

Compliance Management

Job description

Are you passionate about making a meaningful impact on the lives of others? Are you dedicated to providing exceptional care and support? Join our dynamic team where your skills and compassion come together to create a positive difference in the healthcare industry. We are seeking motivated individuals who share our commitment to excellence, innovation, and community well-being. Discover a fulfilling career where your talents align with a mission-driven organization, and together, we can transform healthcare experiences for the better. Join us in shaping a healthier future for all.

Here’s what you’ll be doing:

Responsible for managing high-volume physician enrollment and credentialing processes, ensuring compliance with regulatory standards and supporting audits, documentation, and provider communications.

• Manage high-volume physician enrollment with insurance payers, ensuring timely, accurate processing and compliance with payer requirements.
• Collect, review, and submit credentialing and re-credentialing applications; maintain provider files and documentation in line with NCQA and regulatory standards.
• Support audits, compile credentialing committee materials, track application status, and coordinate follow-up communications with providers and internal teams.

Here’s what you’ll have:

• 5+ years of credentialing or healthcare admin experience with strong knowledge of NCQA guidelines and credentialing processes.

Here’s what you’ll get:

• Above market rate of $27.00 per hour
• Friendly coworkers
• Supportive management invested in your success

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Administrative, Accounting/Auditing, and Health Care Provider

• Industries

  Hospitals and Health Care and Hospitals

Referrals increase your chances of interviewing at Randstad USA by 2x

Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Disability insurance

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