Credentialing Specialist

TITLE: Credentialing Specialist REPORTS TO: Credentialing Manager - Laura Livingston STATUS: Hourly LOCATION: Remote SCHEDULE: Monday – Friday, 8:00 AM – 5:00 PM PAY: $20 - $23.50/hr JOB SUMMARY The Credentialing Specialist supports the Compliance Department by reviewing and validating new and existing customers to ensure compliance with applicable laws, regulations, and company policies. This position is responsible for conducting application reviews, performing customer due diligence, documenting findings, and identifying potential compliance concerns. The Compliance Department is responsible for evaluating customer applications and helping to prevent fraud, misuse of company products and services, and other activities that may present a compliance risk to the organization. JOB RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily, with or without reasonable accommodation: Review, verify, and validate customer applications and supporting documentation to ensure compliance with regulatory requirements and internal policies Conduct comprehensive investigations and due diligence reviews of new and existing customers to identify potential compliance concerns, fraud risks, or policy violations Prepare accurate, detailed, and timely reports summarizing findings, recommendations, and compliance determinations Monitor and assess customer information to ensure ongoing adherence to company standards and applicable regulations Escalate non-compliant activities, suspicious findings, and potential risks to management for review and resolution Collaborate with management and cross-functional teams regarding compliance-related issues and regulatory matters Maintain a thorough understanding of current and emerging regulatory requirements, industry best practices, and company policies and procedures Support departmental audits, compliance reviews, and process improvement initiatives as needed Maintain confidentiality and exercise sound judgment when handling sensitive customer and company information Perform other duties as assigned QUALIFICATIONS High school diploma or equivalent required Strong analytical and investigative skills with exceptional attention to detail Excellent written and verbal communication skills Ability to manage multiple priorities and work effectively in a fast-paced environment while meeting deadlines Demonstrated professionalism, integrity, and strong work ethic Strong understanding of regulatory compliance principles and the ability to exercise sound judgment when evaluating compliance-related matter Proficiency with standard business applications, including Microsoft Office (Word, Excel, Outlook), internet research tools, and database systems Strong organizational skills and the ability to maintain accurate records and documentation Experience with or willingness to learn AI tools and emerging technologies PREFERRED QUALIFICATIONS Associate's or bachelor's degree, or relevant college coursework Prior experience in credentialing, compliance, fraud prevention, risk management, customer verification, or a related field Experience reviewing documentation and conducting research to support compliance decisions REMOTE WORK REQUIRMENTS Stable, high-speed internet connection Experience with teleconferencing Access to a quiet workspace Smartphone/mobile device PHYSICAL DEMANDS While performing the responsibilities of the job, the person in this position will be required to frequently communicate information so others will understand. The person in this position must be able to remain in a stationary position at least 50% of the time and must be able to lift up to 15 pounds at times. The person in this position may need to occasionally move about the inside of an office. The person in this position may need to position self to maintain files in a cabinet and place computers under a desk or in a cabinet. This position requires ability to constantly observe typewritten text on a computer screen. The person in this role is required to operate a laptop and use a telephone regularly. The person in this position may be required to travel throughout the USA by automobile or airplane which may require overnight lodging. WORK ENVIRONMENT While performing the duties of this job, the person in this role may be in a stationary position in an office setting and may be exposed to quiet to moderate noise level. OTHER DUTIES This job description is intended to convey information essential to understanding the scope of the job and the general nature and level of work performed by job holders within this job. This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities or working conditions associated with the position. This job description is subject to change at any time. CBC Companies is committed to equal opportunity employment, and employment decisions are based on merit, qualifications, and abilities. Employment-related decisions are not influenced or affected by an employee’s race, color, gender, age, religion, national origin, disability, citizenship, military status, sexual orientation, genetic information, or any other category protected by federal, state or local law. The Company endorses a work environment free from discrimination and harassment. #J-18808-Ljbffr