Remote Credentialing Specialist III - Data & Compliance

The Guardian Life Insurance Company of America; Newport Beach (CA); Remote; USD 43,000 - 66,000; Full time

Job summary

Guardian is seeking a Credentialing Support Associate III to manage provider records, coordinate recredentialing, and ensure regulatory compliance. You will resolve discrepancies, verify data, and collaborate with internal teams to maintain high-quality credentialing files.

The role emphasizes meticulous data entry, timely communication with providers, and adherence to company standards, with remote work options and a Newport Beach regional office.

Qualifications

• High school diploma or equivalent; an Associate's or Bachelor's degree is preferred.
• Experience supporting provider credentialing or healthcare operations.
• Experience maintaining data in databases or business systems.
• Strong attention to data accuracy and detail.
• 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, 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

Organized

Communication skills

Time management

Data accuracy

Regulatory compliance

Education

Degree preferred

Tools

Excel

Outlook

Job description

Guardian is seeking a Credentialing Support Associate III to manage provider records, coordinate recredentialing, and ensure regulatory compliance. You will resolve discrepancies, verify data, and collaborate with internal teams to maintain high-quality credentialing files.

The role emphasizes meticulous data entry, timely communication with providers, and adherence to company standards, with remote work options and a Newport Beach regional office.