Credentialing Specialist

Ardent Credentialing Specialist

At Ardent, we believe that the "product" in the BPO industry is our people and their time. We partner with mission-driven healthcare organizations to bridge the health literacy gap in the U.S. healthcare system. Our mission is to cut through the red tape of healthcare by pairing patients with expert advocates, ensuring they have the tools to make better decisions and achieve better outcomes.

We are a high-growth, intense, and heart-led team. Ardent isn't a place to coast; it's a place to redefine the patient experience through urgency, precision, and empathy.

Role Overview

Our client is a healthcare credentialing technology company that powers accurate, timely provider credentialing for health plans, digital health companies, and healthcare employers. Our CVO Operations team is the delivery engine behind that promise — responsible for credentialing providers end-to-end so that patients can access care safely and as quickly as possible.

You will manage high-volume provider credentialing workflows for a portfolio of clients across multiple specialties and states. You will work within our clients proprietary credentialing software, follow NCQA-aligned processes, and serve as a quality-first operator who takes ownership of accuracy, turnaround time, and client outcomes. This role is a strong fit for detail-oriented credentialing professionals who thrive in structured, high-accountability environments and want to build deep expertise in credentialing.

While this role is full-time, the position would likely begin in June and end 90-days later.

Core Responsibilities

• Provider Credentialing (Primary Function)
• Manage end-to-end credentialing for a steady caseload of providers across one client.
• Review and process credentialing applications submitted via CAQH ProView or client-specific onboarding forms; identify missing or incomplete information and initiate timely follow-up with providers or clients
• Execute all primary source verifications (PSVs) using our clients software platform, including licensure, education, training, board certification, DEA, NPI, NPDB, and sanctions checks
• Interpret PSV results and apply credentialing judgment to flag discrepancies, exclusions, or items requiring escalation.
• Compile complete, audit-ready credentialing files per client standards and URAC guidelines
• Meet or exceed weekly productivity targets (case volume) while maintaining individual quality metrics at or above team benchmarks
• Credentialing File Management
• Maintain accurate, up-to-date provider records in our clients or the client's platform throughout the credentialing lifecycle
• Client & Stakeholder Communication
• Coordinate with providers, office managers, and client contacts via email to collect outstanding documentation; outreach is via e-mail and largely automated; at most, a team member will need to document notes following our scripts to make clear to providers what information is missing from their credentialing application.
• Represent our client with professionalism and a client-focused attitude.
• Process & Tooling
• Use Salesforce (CRM) and our client's platform as primary workflow management tools; log all case activity accurately
• Contribute observations about workflow inefficiencies or recurring errors to Team Lead for process improvement discussion
• Complete assigned training, onboarding milestones, and any compliance certifications within the required timeframe

Required Qualifications

• Experience
• 1+ years of direct credentialing operations experience — physician and/or advanced practice provider (APP) credentialing strongly preferred
• Demonstrated ability to manage concurrent credentialing files across multiple provider types
• Experience with CAQH ProView: pulling profiles, identifying discrepancies and gaps
• Familiarity with NCQA credentialing standards (CR elements) and/or URAC standards; understanding of PSV requirements and acceptable verification sources
• Experience running or interpreting primary source verifications: state licensing boards, DEA, NPI Registry, NPDB, OIG/SAM exclusion checks
• Technical Skills
• Proficiency with Google Suite (Gmail, Google Docs, Google Sheets) for daily communication and documentation
• Salesforce or comparable CRM experience for case logging and task management
• Comfort operating within SaaS-based credentialing platforms; ability to learn new software quickly
• Basic proficiency with Adobe Acrobat for document review and file assembly
• Professional Competencies
• Exceptional attention to detail — errors in credentialing have downstream patient safety implications; accuracy is non-negotiable
• Strong written communication skills for provider correspondence; professional and clear across all channels
• Self-directed work habits suitable for a fully remote environment; reliable follow-through on assigned tasks without close supervision
• Collaborative mindset — willing to flag issues early, ask questions, and contribute to process improvement

Preferred Qualifications

• Experience in a CVO, MSO, or delegated credentialing environment
• CPCS (Certified Provider Credentialing Specialist) or CPMSM credential a bonus
• Experience credentialing behavioral health, telehealth, or digital health providers
• Prior experience in a BPO or high-volume shared services credentialing operation

Up for the challenge? We're looking for someone with heart, grit, and a "get it done" mentality. If you're ready to do the best work of your life, we look forward to meeting you.

This job description is intended to convey the general nature and scope of the role. Responsibilities may evolve based on business need. Ardent is an equal opportunity employer.