Provider Credentialing Specialist

Working remotely in a full-time capacity, the Provider Credentialing Specialist II will manage credentialing and re-credentialing processes for a managed care organization, ensuring compliance with relevant regulations and conducting primary source verifications for various healthcare providers. Key responsibilities: Review and process credentialing applications and re-credentialing for medical and behavioral providers Ensure adherence to National Committee for Quality Assurance, State, and Federal regulations Conduct timely and efficient primary source verifications for facility and ancillary providers Required qualifications: High School diploma or equivalent required Minimum of 2 years of directly related experience in managed care provider credentialing Thorough knowledge of credentialing principles, methods, regulations, and procedures Experience with Credential Stream or similar credentialing software preferred CPCS certification as a Certified Provider Credentialing Specialist preferred