Remote Credentialing Specialist I — Healthcare Ops

Centene Corp.; North Carolina; Hybrid; USD 27,000 - 45,000; Full time

Job summary

Centene Corp. is hiring for a remote credentialing specialist who will perform credentialing and re-credentialing according to plan specifications and NCQA standards.

You will communicate with physicians, managers, providers, and third parties to secure needed data and prepare materials for Credentialing Committee meetings. The role requires 1+ years in data entry or healthcare operations, with an Associate’s degree or equivalent.

Qualifications

• Associate’s degree or high school diploma/equivalent with related experience.
• 1+ years in data entry, customer service, medical office, or credentialing.
• Experience in managed care or insurance environment preferred; PSV verification helpful.

Responsibilities

• Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards
• Communicate with physicians, office managers, providers and third parties to obtain information
• Gather information for Credentialing Committee meetings
• Process, track and file credentialing applications within standards
• Generate and use reporting to support business functions
• Thrive in a fast-paced production environment while maintaining quality
• Perform PSV for education verification

Skills

Data entry

Customer service

Provider data management

Credentialing

Healthcare operations

Education

Associate’s degree

High school diploma or equivalent

Job description

Centene Corp. is hiring for a remote credentialing specialist who will perform credentialing and re-credentialing according to plan specifications and NCQA standards.

You will communicate with physicians, managers, providers, and third parties to secure needed data and prepare materials for Credentialing Committee meetings. The role requires 1+ years in data entry or healthcare operations, with an Associate’s degree or equivalent.