Provider Credentialing Specialist: NCQA & Data Verification

Elevait Solutions; Philadelphia (Philadelphia County); On-site; USD 45,000 - 65,000; Full time

Job summary

A healthcare solutions company is seeking a Credentialing Specialist in Philadelphia. The role involves processing provider applications, conducting verifications, and ensuring compliance with NCQA and legal standards. Candidates should possess strong verbal and written communication skills, along with the ability to work in a metrics-driven environment. Proficiency in Microsoft Office is also required. This position offers a full-time commitment for over 5 months, providing an opportunity to delve into the credentialing field.

Qualifications

• Intermediate knowledge of PC applications including Microsoft Office.
• Strong verbal and written communication skills.
• Strong organizational skills.
• Ability to perform in a metrics-driven environment.

Responsibilities

• Validates completeness of provider applications before processing.
• Conducts primary source verification for all credentialing applications.
• Monitors the completion of all site visits by the provider network team.
• Accurately enters critical data elements into the Credentialing system.
• Responds to phone inquiries from internal and external clients.
• Completes assigned projects.

Skills

Intermediate knowledge of PC applications

Strong verbal communication skills

Strong written communication skills

Strong organizational skills

Ability to perform in a metrics-driven environment

Tools

Microsoft Office

Job description

A healthcare solutions company is seeking a Credentialing Specialist in Philadelphia. The role involves processing provider applications, conducting verifications, and ensuring compliance with NCQA and legal standards. Candidates should possess strong verbal and written communication skills, along with the ability to work in a metrics-driven environment. Proficiency in Microsoft Office is also required. This position offers a full-time commitment for over 5 months, providing an opportunity to delve into the credentialing field.