Credentialing Specialist (REMOTE- FL) Position Available In [Unknown county], Florida

Credentialing Specialist (REMOTE•FL) 3.3 3.3 out of 5 stars Florida • Remote BC Forward is looking for Credentialing Specialist (REMOTE) in Florida About BCforward Founded in 1998, BCforward is a Black-owned global leader in workforce management and digital product delivery solutions, headquartered in Indianapolis, IN. With a worldwide team of over 6,000 consultants, BCforward is dedicated to empowering human potential through its core values: People-Centricity, Excellence, and Diversity. As an industry pioneer, BCforward provides a best-in-class workplace, fostering a culture of accountability, innovation, and optimism. Committed to equal opportunity employment, the company champions diversity and inclusion, striving to create a positive impact for its clients, employees, and communities.

Position Title:

Delegation/Credentialing Specialist (REMOTE)

Locations:

Remote•

FL Anticipated Start Date:

6/16

Expected Duration:

6

Months Job Type:

Contract with possible extension

Shift:

8:00am•4:30 pm Pay Rate $30.00/hr. on W2

Need:

Requires proficiency in Excel (data analysis and reporting), strong reporting experience, and at least 5 years in a corporate setting, with NAMSS Credentialing Certification and familiarity with NCQA Standards as a plus.

Interview Process:

1•Phone Screen, 2•Video Interview.

Job Description:

Job Title:

Delegation Specialist Position Purpose:

Serve as a primary liaison for delegated entities, overseeing auditing, reporting, and compliance activities to ensure alignment with NCQA requirements and organizational standards. Maintain high-quality delegation partnerships and support the Delegation Team in managing all delegated provider functions and activities.

Key Responsibilities:

Conduct delegation audits for assigned functional areas. Communicate reporting requirements and expectations to delegated entities. Ensure ongoing compliance with delegation oversight requirements and NCQA standards. Maintain and update policies and procedures related to delegation processes. Support Credentialing Committee activities as needed. Report audit findings and delegation monitoring results to leadership. Build and maintain successful delegation partnerships to ensure quality standards are met. Process provider requests from delegated entities received via shared mailbox. Manage monthly delegated rosters and perform reconciliation tasks. Verify and maintain accurate provider data across all systems. Collect and manage required annual documents (e.g., W-9s, Disclosure of Ownership). Facilitate repapering of all delegated entities with updated contract agreements. Prepare and compile pre-delegation packets for prospective delegated entities. Conduct background screenings and quarterly subcontractor/affiliate reporting. Attend internal and external meetings as required. Support internal teams and participate in special projects as assigned. Ensure all tasks are completed within the required 45-day turnaround time. Comply with all organizational policies, procedures, and standards.

Education and Experience Requirements:

Required:

Bachelor’s degree in Business, Healthcare, or a related field (or equivalent experience). Minimum of 2 years’ experience in delegation, credentialing, or provider data management. Minimum of 5 years of experience in a corporate or professional setting.

Preferred:

NAMSS Credentialing Certification. Familiarity with NCQA standards and requirements.

Licenses/Certifications:

Valid driver’s license and current car insurance (may be required depending on the health plan). Skills and Competencies (Ranked by Importance):

Excel & Reporting Proficiency:

Strong skills in Excel (formulas, pivot tables, data reconciliation). Ability to manage and interpret reporting data for audits and compliance tracking.

Communication Skills:

Exceptional written and verbal communication for internal and external interactions.

Time Management & Organization:

Ability to prioritize, multitask, and meet strict deadlines (e.g., 45-day turnaround). Strong problem-solving and judgment in a fast-paced environment.

Team Structure & Culture:

The Delegation Team includes four Delegation Specialists and one Senior Delegation Specialist. Highly collaborative and mission-focused environment. Emphasis on quality, accountability, and continuous improvement.

Expected performance:

300 monthly submissions per staff member once fully trained.

Work Environment & Schedule:

Standard schedule: Monday-Friday, 8:00 AM•4:30 PM (some flexibility available). Remote and/or hybrid work arrangements may apply depending on the health plan. Overtime opportunities available upon meeting performance metrics. Independent work expected post-training, while remaining a collaborative team contributor. Why This Role is

Compelling:

Opportunity to develop and enhance delegation management skills in a growing team. Direct impact on provider satisfaction and member outcomes through timely and accurate processing. Chance to work in a team preparing for and navigating NCQA audits — enhancing compliance experience. Provides a stable and supportive environment where attention to detail and initiative are rewarded.

Job Types:

Full-time, Contract Pay:

$30.00 per hour Expected hours: 40 per week

Benefits:

Dental insurance Health insurance Vision insurance

Schedule:

8 hour shift Day shift Monday to

Friday Location:

Florida (Required)

Work Location:

Remote