We are seeking Credentialing Specialists to support a temporary assignment addressing a current backlog in health plan credentialing. This role focuses on primary source verification and credentialing of practitioner and hospital provider records across multiple health plans. This is a remote position requiring strong time management, accountability, and the ability to work independently in a secure, distraction-free home environment due to the sensitive nature of the information handled.
Key ResponsibilitiesProcess credentialing applications for practitioners and NPs (approximate benchmark of 4 applications per hour).Perform primary source verification of practitioner licensure, certifications, and credentials, confirming they are current, accurate, and match submitted documentation.
Identify discrepancies in provider information and conduct follow-up to resolve them.
Handle Protected Health Information (PHI) in accordance with privacy and security standards.
Navigate and work across approximately 5 different systems, including CredentialStream, to complete verifications.
Maintain accurate, up-to-date provider records within the credentialing database.
Perform administrative and verification duties as part of the end-to-end credentialing process.
Maintain accuracy, organization, and attention to detail throughout the credentialing workflow.