Remote Credentialing & Provider Data Specialist

GlobalHealth, Inc.; Oklahoma City (OK); On-site; USD 42,000 - 64,000; Full time

Job summary

GlobalHealth, Inc. is seeking a Provider Coordinator to ensure data integrity for provider directories and to respond to inquiries with research and resolution. This role supports credentialing activities while maintaining CMS compliance and timely processing of applications.

Working remotely from the United States, you will collaborate cross-functionally to validate data accuracy, update records, and coordinate initial and recredentialing for providers in line with CMS standards.

Qualifications

• High School diploma or equivalent required.
• Three to five years of credentialing experience.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
• Knowledge of CMS, NCQA and state regulatory requirements related to provider credentialing and directory accuracy.

Responsibilities

• Verify Provider Data integrity with ongoing monitoring and respond to daily inquiries.
• Assist in maintaining accurate Provider/Vendor records and Provider Directory.
• Educate and assist providers to maximize data integrity and provider experience.
• Meet CMS guidelines and ensure compliance across processes.
• Process credentialing paperwork, verifying completeness and accuracy.

Skills

Data entry

CMS knowledge

NCQA knowledge

Provider relations

Research and problem solving

HIPAA compliance

Education

High School diploma or equivalent

Three to five years credentialing experience

Tools

Microsoft Word

Outlook

Excel

JIRA

Job description

GlobalHealth, Inc. is seeking a Provider Coordinator to ensure data integrity for provider directories and to respond to inquiries with research and resolution. This role supports credentialing activities while maintaining CMS compliance and timely processing of applications.

Working remotely from the United States, you will collaborate cross-functionally to validate data accuracy, update records, and coordinate initial and recredentialing for providers in line with CMS standards.