Remote Credentialing Specialist III

The Guardian Life Insurance Company of America; Washington; Ibrido; USD 36.000 - 55.000; Tempo pieno

Descrizione del lavoro

Guardian Life Insurance Company of America is seeking a Credentialing Support Associate III to maintain accurate provider records and support credentialing and recredentialing for vision, dental, and hearing providers. You will coordinate outreach, verify information, and ensure compliance with regulatory and NCQA standards.

You will work with providers and internal teams to resolve discrepancies, track requirements, and uphold data quality in a fast-paced environment.

Competenze

• 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 and updating 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.

Mansioni

• 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.

Conoscenze

Provider credentialing experience

Data entry / data management

Attention to detail

Communication

Regulatory compliance

Time management

Multitasking

MS Office (Excel, Outlook)

Credentialing software

Formazione

High school diploma or equivalent; Associate's or Bachelor's degree preferred

Strumenti

Microsoft Excel

Microsoft Outlook

Descrizione del lavoro

Guardian Life Insurance Company of America is seeking a Credentialing Support Associate III to maintain accurate provider records and support credentialing and recredentialing for vision, dental, and hearing providers. You will coordinate outreach, verify information, and ensure compliance with regulatory and NCQA standards.

You will work with providers and internal teams to resolve discrepancies, track requirements, and uphold data quality in a fast-paced environment.