Remote Managed Care Credentialing Specialist II

BPI Burrell Preferred Inc.; United States; Remote; USD 50,000 - 70,000; Full time

Benefits offered by this job

Paid time off

Health benefits package

Top-notch training

Career mobility

Welcoming culture

Job summary

Brightli is seeking a Managed Care Credentialing Representative II to support providers as they join and grow within our network, ensuring their onboarding and credentialing journey is seamless, accurate, and compliant with regulatory standards.

You will maintain detailed provider files, manage credentialing data, and collaborate with teams to ensure timely recredentialing while upholding a customer-focused, organized, and detail-oriented approach in a mission-driven healthcare environment.

Qualifications

• High school diploma, GED, or equivalent required.
• Previous healthcare credentialing experience required.
• Experience in healthcare administration utilizing advanced Microsoft Office tools, including Excel, preferred.

Responsibilities

• Guide onboarding providers through credentialing application and enrollment processes, answering questions and providing clear, supportive direction.
• Complete initial credentialing and recredentialing applications while proactively monitoring progress and following up to meet required timelines.
• Compile, verify, and maintain accurate provider data within credentialing databases and files.
• Investigate and document practitioner credentials, including education, training, licensure, and professional history, in accordance with regulatory standards.
• Communicate adverse or questionable verification findings to supervisors and leadership as needed.
• Assist providers with changes to privileges or license types.
• Maintain departmental standards while ensuring compliance with all applicable credentialing regulations.
• Perform other related duties as assigned.

Skills

Customer service

Communication

Time management

Organizational skills

Analytical ability

Education

High school diploma or equivalent

Job description

Brightli is seeking a Managed Care Credentialing Representative II to support providers as they join and grow within our network, ensuring their onboarding and credentialing journey is seamless, accurate, and compliant with regulatory standards.

You will maintain detailed provider files, manage credentialing data, and collaborate with teams to ensure timely recredentialing while upholding a customer-focused, organized, and detail-oriented approach in a mission-driven healthcare environment.