Remote Credentialing Analyst — Part-Time Contract

Elevance Health; Northern (KY); Hybrid; USD 28,000 - 52,000; Part time

Job summary

BCForward is seeking a contract credentialing specialist to support Elevance Health. You will perform credentials file audits for timeliness and documentation quality, and conduct quality reviews for Medical Director and Credentials Committee.

This role is remote with a hybrid workforce model, 9:00 am–5:00 pm CT, up to 20 hours per week; in-office presence may be required periodically. Candidates should have HS diploma and 3 years in managed care; Certified Provider Credentialing Specialist

Qualifications

• Requires HS diploma or equivalent and minimum of 3 years experience in a managed care environment.
• Certified Provider Credentialing Specialist preferred.
• Strong documentation and accuracy across credentialing processes.

Responsibilities

• Performs credentials file audits to ensure timeliness of processing, quality of documentation, and adherence to policies.
• Performs quality review of files for accuracy and completeness for Medical Director and Credentials Committee.
• Interacts with physicians and credentialing staff to obtain information and provide updates.
• Utilizes internal systems and runs reports to research provider questions and resolve issues.
• Monitors license actions, complaints, and sanctions and gathers information for Managers review.
• Prepares documentation for Medical Directors consideration of off-cycle review.

Skills

Interpersonal communication

Documentation accuracy

Data analysis

Education

HS diploma or equivalent

Certified Provider Credentialing Specialist

3 years experience in a managed care environment

Tools

Credentialing systems

Job description

BCForward is seeking a contract credentialing specialist to support Elevance Health. You will perform credentials file audits for timeliness and documentation quality, and conduct quality reviews for Medical Director and Credentials Committee.

This role is remote with a hybrid workforce model, 9:00 am–5:00 pm CT, up to 20 hours per week; in-office presence may be required periodically. Candidates should have HS diploma and 3 years in managed care; Certified Provider Credentialing Specialist