Remote Credentialing Analyst — Flexible Hours & Growth

Elevance Health; Nashville (TN); Hybrid; USD 60,000 - 85,000; Full time

Job summary

Elevance Health in the United States is seeking a Credentialing Analyst to support provider credentialing, research, audits, and credentialing appeals. This role includes site visits, delegation oversight and collaboration with internal teams to ensure timely processing and high-quality documentation.

A HS diploma and at least 3 years in a managed care environment are required; familiarity with NPPES, PECOS, CAQH is preferred.

Qualifications

• HS diploma or equivalent required
• Minimum 3 years' experience in a managed care environment

Responsibilities

• Supports licensing and credentialing efforts for a national virtual provider group
• Performs credentialing file audits to ensure timeliness and documentation quality
• Reviews files for accuracy and completeness with vendors
• Analyzes performance data to standards
• Interacts with clinical leadership to obtain information and status updates
• Uses internal systems and runs reports to research questions and resolve issues
• Monitors license actions, complaints and sanctions and escalates as needed

Job description

Elevance Health in the United States is seeking a Credentialing Analyst to support provider credentialing, research, audits, and credentialing appeals. This role includes site visits, delegation oversight and collaboration with internal teams to ensure timely processing and high-quality documentation.

A HS diploma and at least 3 years in a managed care environment are required; familiarity with NPPES, PECOS, CAQH is preferred.