Remote Credentialing Specialist – Provider Verification

Moda Partners, Inc.; Oregon; Hybrid; USD 27,000 - 30,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401K matching

FSA

EAP

PTO and holidays

Job summary

Moda Health in Oregon seeks a Credentialing Verifier to perform credentialing and re-credentialing for contracted providers in compliance with NCQA and state/federal standards.

This is a full-time position offering remote or hybrid work options, with pay range $19.43–$21.86 per hour depending on qualifications. Applicants should have strong organizational skills and familiarity with credentialing standards.

Qualifications

• Typing speed of at least 50 words per minute and Ten key proficiency (135 kspm) is required.
• Strong organizational and time management abilities with attention to deadlines.
• Ability to handle confidential information and work independently or in a team.
• Knowledge of NCQA, CMS and Oregon credentialing standards is helpful.
• Excellent verbal and written communication and strong interpersonal skills.
• Maintain professional appearance in all interactions.

Responsibilities

• Verify credentials timely and accurately from approved sources on the Moda panel.
• Monitor requests for credentialing and re-credentialing applications.
• Complete documentation and data entry into the credentialing database.
• Identify and report non-compliance or credentialing issues to the supervisor.
• Communicate with providers or staff about status and required documents.
• Update provider demographics in the database.
• Manage provider data within delegated credentialing systems.
• Maintain confidentiality of documents and data; handle all items securely.
• Perform other duties as assigned.

Skills

Typing 50 wpm

Ten key 135 kspm

Organizational skills

Time management

Deadlines & confidentiality

Problem solving

NCQA / CMS / Oregon credentialing know

Verbal & written communication

Interpersonal skills

Professional appearance & demeanor

Job description

Moda Health in Oregon seeks a Credentialing Verifier to perform credentialing and re-credentialing for contracted providers in compliance with NCQA and state/federal standards.

This is a full-time position offering remote or hybrid work options, with pay range $19.43–$21.86 per hour depending on qualifications. Applicants should have strong organizational skills and familiarity with credentialing standards.