Provider Credentialing Specialist

Health One Alliance, LLC; Dalton (GA); Hybrid; USD 40,000 - 60,000; Full time

Benefits offered by this job

401(k) (4% Match, Immediate Vesting)

Competitive salary

Medical Insurance

Paid Time Off

Job summary

Health One Alliance, LLC is seeking a Credentialing Representative to manage the credentialing and recredentialing of providers in compliance with NCQA standards. The role requires working directly with providers and preparing documentation for credentialing committee meetings.

Applicants should have a high school diploma, strong self-motivation, and familiarity with insurance terms. The position offers comprehensive benefits including medical and dental insurance, 401(k) matching, and paid time off.

Qualifications

• Requires a minimum of one year of health plan experience.
• One to three years of general work experience.
• Ability to learn quickly and adapt to changing guidelines.

Responsibilities

• Responsible for credentialing and recredentialing of providers.
• Works directly with providers to ensure all necessary credentialing information has been received.
• Prepares and presents providers’ records for credentialing committee review.

Skills

Self-motivated

Knowledge of credentialing processes

Intermediate skill with Microsoft Excel

Familiarity with insurance terms

Education

High school diploma or its equivalent

Tools

Microsoft Excel

Microsoft Word

Job description

Health One Alliance, LLC is seeking a Credentialing Representative to manage the credentialing and recredentialing of providers in compliance with NCQA standards. The role requires working directly with providers and preparing documentation for credentialing committee meetings.

Applicants should have a high school diploma, strong self-motivation, and familiarity with insurance terms. The position offers comprehensive benefits including medical and dental insurance, 401(k) matching, and paid time off.