Credentialing Specialist

Randstad USA; United States; On-site; USD 40,000 - 70,000; Full time

Job summary

Join a mission-driven organization as a Credentialing Specialist, where you'll manage physician enrollment and ensure compliance with regulatory standards. With a focus on excellence and community well-being, this role offers a fulfilling career in healthcare. Enjoy a supportive work environment and competitive pay.

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 maintain provider documentation.

Skills

Healthcare Admin

Credentialing

Compliance

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

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Disability insurance

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