Credentialing Specialist I

In this role, you will play a vital part in verifying provider qualifications, conducting education checks, and managing documentation within strict industry and NCQA guidelines. You will handle daily high-volume data entry, process credentialing files, and communicate professionally with physicians, medical office managers, and third-party contacts. Success in this position is measured by your speed, accuracy, and adherence to established turnaround metrics in a dynamic, deadline-driven setting. The ideal candidate brings data entry capabilities, excellent customer service skills, and proficiency in MS Outlook and Excel. Key Responsibilities: • Process, track, and file credentialing and re-credentialing applications in compliance with NCQA and plan specifications. • Conduct education verification and qualification screenings for healthcare providers during initial credentialing. • Manually enter records, provider data, and documentation into internal systems daily within assigned timeframes. • Communicate professionally via phone and email with physicians, office managers, and third parties, maintaining a 3–5 day turnaround window. • Gather documentation and generate reporting to support Credentialing Committee meetings and business operations. Qualifications & Requirements: • High School Diploma/equivalent required (Associate degree preferred). • 1+ years of experience in data entry, customer service, medical office, or credentialing operations. • Proven experience with education verification for providers in the initial credentialing process. • Top Skills: 1. Fast & accurate Data Entry; 2. Professional Customer Service; 3. Proficiency in Microsoft Outlook and Excel. • attention to detail with proven ability to meet strict daily deadlines and production metrics.

salary: $22.99 - $23 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

• Process, track, and file credentialing and re-credentialing applications in compliance with NCQA and plan specifications.
• Conduct education verification and qualification screenings for healthcare providers during initial credentialing.
• Manually enter records, provider data, and documentation into internal systems daily within assigned timeframes.
• Communicate professionally via phone and email with physicians, office managers, and third parties, maintaining a 3–5 day turnaround window.
• Gather documentation and generate reporting to support Credentialing Committee meetings and business operations.

Skills

• Data Entry
• Customer Service
• Outlook and Excel

Qualifications

• Years of experience: 1 year
• Experience level: Experienced

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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.