Senior Credentialing Specialist (Hybrid)

Elevance Health, Inc.; Nashville (TN); Hybrid; USD 33,000 - 50,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive programs

401k contribution

Stock purchase plan

Job summary

Elevance Health, Inc. is seeking a Credentialing Specialist Senior for a hybrid role based in New York. The position audits colleagues, reviews credentialing documentation, and handles complex credentialing and accreditation inquiries while ensuring compliance and data integrity.

Ideal candidates have a HS diploma and 4+ years in credentialing, with CPCS or CMSC preferred. The company emphasizes equal pay and robust benefits within a hybrid work model.

Qualifications

• Requires a High School diploma or equivalent and a minimum of 4 years credentialing experience.
• Alternative combinations of education and experience may qualify.

Responsibilities

• Audits work of other credentialing associates.
• Compiles and reviews documentation required by credentialing committee.
• Responds to the most complex provider credentialing, compliance and accreditation issues.
• Researches pended and probated applications and resolves discrepancies.
• Monitors reports identifying practitioners on sanctions or those who do not meet credentialing criteria for further action and assists in researching related issues.
• May assist in delegation oversight and identifies on-going training needs.
• Assists in developing training materials.

Skills

Credentialing

Auditing

Documentation

Research

Education

High School Diploma or equivalent

4 years credentialing experience

Job description

Elevance Health, Inc. is seeking a Credentialing Specialist Senior for a hybrid role based in New York. The position audits colleagues, reviews credentialing documentation, and handles complex credentialing and accreditation inquiries while ensuring compliance and data integrity.

Ideal candidates have a HS diploma and 4+ years in credentialing, with CPCS or CMSC preferred. The company emphasizes equal pay and robust benefits within a hybrid work model.