Remote Provider Credentialing Specialist II

Sentara Workforce Solutions, LLC; Raleigh (NC); Remote; USD 24,000 - 40,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

Tuition Assistance

Paid Time Off

Job summary

Sentara Health Plan is hiring a Provider Credentialing Specialist II - Remote. The role performs credentialing and re-credentialing processing for a managed care organization, ensuring compliance with NCQA and state/federal regulations.

Remote opportunities are available in multiple states. The position requires a minimum of 2 years of directly related credentialing experience and offers 40 hours weekly, typically 8am–5pm EST, Monday–Friday.

Qualifications

• Minimum of 2 years of directly related credentialing experience REQUIRED.
• Thorough knowledge of managed care credentialing/re-credentialing principles, methods, regulations, and procedures.

Responsibilities

• Review, investigate, and process primary source verifications for facility, ancillary, medical and behavioral providers in a timely, efficient manner.
• Assist with credentialing and re-credentialing processing under supervision of a Credentialing Supervisor/Manager.
• Ensure compliance with NCQA, state and federal regulations.

Skills

Credentialing knowledge

Credentialing experience

CPCS certification

Education

High school diploma or equivalent

Tools

Credential Stream

MDStaff

Cactus

Job description

Sentara Health Plan is hiring a Provider Credentialing Specialist II - Remote. The role performs credentialing and re-credentialing processing for a managed care organization, ensuring compliance with NCQA and state/federal regulations.

Remote opportunities are available in multiple states. The position requires a minimum of 2 years of directly related credentialing experience and offers 40 hours weekly, typically 8am–5pm EST, Monday–Friday.