Remote Credentialing Specialist III

Guardian; California; Remote; USD 44,000 - 66,000; Full time

Job summary

Guardian seeks a Credentialing Support Associate III to maintain provider records and support the credentialing process. You will coordinate outreach, validate information, and ensure compliance with regulatory and organizational requirements in collaboration with providers and internal stakeholders.

You will manage data integrity across credentialing systems, handle recredentialing communications, and assist in improving credentialing workflows to support high-quality provider network

Qualifications

• High school diploma or equivalent; Associate's or Bachelor's degree preferred.
• Experience supporting provider credentialing, healthcare operations, provider enrollment, or administrative processes.
• Experience maintaining data within databases or business systems.
• Strong attention to detail and commitment to data accuracy.
• Excellent verbal and written communication skills.
• Ability to follow established processes and regulatory requirements.
• Strong organizational and time management skills.
• Ability to manage multiple priorities in a deadline-driven environment.
• Proficiency with Microsoft Office applications, including Excel and Outlook.

Responsibilities

• Maintain accurate provider information by entering, updating, and auditing data within credentialing systems.
• Coordinate recredentialing activities, including distributing recredentialing communications and monitoring provider responses.
• Communicate with providers to obtain missing documentation, resolve discrepancies, and ensure complete credentialing files.
• Conduct primary source verification activities for initial credentialing and recredentialing applications in accordance with regulatory requirements and company standards.
• Track and follow up on outstanding credentialing requirements to support timely processing and compliance.
• Partner with internal stakeholders to ensure provider records are accurate, complete, and compliant with organizational policies.
• Support continuous improvement efforts that enhance credentialing processes and data quality.

Skills

Attention to detail

Data integrity

Microsoft Excel

Verbal & written communication

Regulatory compliance

Time management

Education

High school diploma

Associate's or Bachelor's preferred

Tools

Credentialing software

Provider management systems

Job description

Guardian seeks a Credentialing Support Associate III to maintain provider records and support the credentialing process. You will coordinate outreach, validate information, and ensure compliance with regulatory and organizational requirements in collaboration with providers and internal stakeholders.

You will manage data integrity across credentialing systems, handle recredentialing communications, and assist in improving credentialing workflows to support high-quality provider network