Remote Credentialing Specialist: NCQA and Audit Ready

Transcarent; United States; A distancia; USD 60.000 - 80.000; Jornada completa

Descripción de la vacante

Transcarent is seeking a Credentialing Coordinator to manage day-to-day provider credentialing and re-credentialing, ensuring NCQA-compliant, audit-ready files.

You will verify licenses, board certifications, education, and work history; review applications against requirements; and collaborate across compliance, licensing, and network operations to resolve issues.

A strong analytical mindset, attention to detail, and ability to work independently are essential.

Formación

• 3+ years in provider credentialing or healthcare operations
• Working knowledge of NCQA credentialing standards and primary source verification
• Familiarity with licensure requirements across multiple states
• Strong analytical, detail-oriented, and organizational skills
• Ability to work independently and as part of a team

Responsabilidades

• Execute day-to-day credentialing and re-credentialing tasks
• Review provider files against NCQA standards and payer requirements
• Perform primary source verification of licensure, board certification, education, work history, and sanctions checks
• Assist with delegated credentialing audits and payer submissions
• Collaborate with credentialing, licensing, compliance, and network operations teams
• Document findings in the credentialing database and escalate non-standard issues
• Maintain policies and workflows for audits

Conocimientos

Analytical mindset

Attention to detail

Time management

Communication skills

Educación

Diploma or related field

Herramientas

Verifiable

Availity

CAQH

Descripción del empleo

Transcarent is seeking a Credentialing Coordinator to manage day-to-day provider credentialing and re-credentialing, ensuring NCQA-compliant, audit-ready files.

You will verify licenses, board certifications, education, and work history; review applications against requirements; and collaborate across compliance, licensing, and network operations to resolve issues.

A strong analytical mindset, attention to detail, and ability to work independently are essential.