Credentialing Senior Representative - MD Live - Remote

Position Description The Provider Credentialing Senior Representative is responsible for executing core credentialing and provider data management functions to ensure compliance with regulatory and organizational standards. This role supports the full credentialing lifecycle, including initial credentialing, re‑credentialing, and privileging of providers, while maintaining accurate records and delivering high‑quality service to internal and external stakeholders. Essential Job Functions Perform delegated credentialing activities, including initial credentialing, re‑credentialing, and privileging in accordance with established policies and procedures. Process provider applications and re‑applications, including distribution, review for completeness, and system data entry. Verify provider credentials, including licenses, certifications, and other regulatory requirements. Maintain accurate provider profiles within credentialing and provider management systems. Prepare credentialing files and documentation for committee review, ensuring completeness and compliance. Manage incoming communications in the Credentialing and Verifications and Government Programs inbox, ensuring timely and accurate responses. Respond to provider inquiries related to credentialing status, liability coverage, licensure updates, and demographic/profile changes. Process employment and credentialing verification requests in a timely manner. Triage and route incoming requests and inquiries to appropriate internal departments for resolution. Support Medicaid provider enrollment activities, including maintaining accurate enrollment records and ensuring proper state linkages. Conduct routine audits and assist with departmental projects and process improvement initiatives. Identify and proactively address potential issues, demonstrating forward planning and problem‑solving capabilities. Resolve non‑routine or escalated issues and provide guidance to junior team members as needed. Education and Experience 2+ years of experience in provider credentialing, provider enrollment, or healthcare operations (preferred). Knowledge of credentialing standards, regulatory requirements, and verification processes. Experience with Medicaid enrollment processes and multi‑state provider management (preferred). Strong attention to detail with the ability to manage multiple priorities in a fast‑paced environment. Excellent written and verbal communication skills. Ability to work independently while collaborating cross‑functionally. Proficiency with credentialing systems, databases, and Microsoft Office tools. Organizational and time‑management skills. Problem‑solving and critical thinking. Customer service orientation. Process improvement mindset. Work Conditions Work from home occasionally or permanently requires an internet connection via cable broadband or fiber optic with speeds of at least 10Mbps download and 5Mbps upload. Compensation Hourly rate of 21–32USD, depending on experience and geographic location. Eligible to participate in an annual bonus plan. Benefits Health‑related benefits including medical, vision, dental, well‑being, and behavioral health programs; 401(k); company‑paid life insurance; tuition reimbursement; at least 18 days of paid time off per year; paid holidays; and leaves of absence. Equal Employment Opportunity Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth, lactation, sexual orientation, gender identity, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, public assistance status or citizenship status, or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email View email address on click.appcast.io for assistance. This email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco‑free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Qualified applicants with criminal histories will be considered in a manner consistent with all federal, state, and local ordinances. #J-18808-Ljbffr Cigna Health and Life Insurance Company