Sr. Credentialing Rep

Job Description

Job Description

Job Profile

Job Title:  Sr. Credentialing Representative

Location: Minneapolis MN 55440-9472 

Hire Type: Contingent

Pay Range: $30/hr.

Work Model:   Remote/onsite only twice a year

Work Shift:  Monday-Friday 8:00 am -5:00 pm

Recruiter Contact: Sean Craft I View email address on ziprecruiter.com I View phone number on ziprecruiter.com

Nature & Scope:

Positional Overview

The  Sr. Credentialing Representative will play a key role within the Credentialing Compliance team, ensuring compliance with regulatory, accreditation, and payor requirements. This position supports internal and external audits, accreditation surveys, sanction monitoring, reporting, and sub-delegation oversight. The role requires strong organizational and communication skills, the ability to prioritize in a fast-paced environment, and a collaborative approach to supporting both the Credentialing Compliance team and the larger Credentialing department.

Role & Responsibility:

Tasks That Will Lead To Your Success

• Perform ongoing sanction monitoring of providers and entities.
• Prepare and maintain accurate credentialing reports and documentation.
• Conduct oversight of sub-delegated entities, ensuring compliance with delegation requirements.
• Support internal and external audit processes and accreditation surveys.
• Serve as on-site liaison for audits as needed.
• Prepare materials and deliverables for the Credentialing Committee.
• Provide administrative and compliance support to the Credentialing Compliance team.
• Respond to internal and external inquiries in a timely and professional manner.
• Participate in special projects and other duties as assigned.

Skills & Experience

Qualifications That Will Help You Thrive

• High School Diploma or GED required.
• CPCS (Certified Provider Credentialing Specialist) certification is preferred.
• Credentialing background strongly preferred; healthcare industry experience desirable.
• Strong verbal and written communication skills.
• Proficiency in Microsoft Office Suite, especially Excel.
• Ability to work independently and collaboratively in a team environment.
• Strong organizational skills with the ability to prioritize and manage multiple tasks in a fast-paced setting.
• Positive attitude, reliability, and willingness to learn.