Credentialing Specialist (Full Remote)

Job Title: Remote Temp-to-Perm Credentialing Specialist
Pay: $22/hour
Schedule: Monday to Friday, 8:00 AM - 4:30 PM EST
** Priority given to EST Time Zone candidates **
Benefits: Offered

Job Description
The Credentialing Specialist is responsible for coordinating all aspects of the credentialing and primary source verification process for practitioners and health delivery organizations. This role requires attention to detail, excellent communication skills, and the ability to maintain confidentiality while working in a fast-paced, remote environment.

Key Responsibilities

Data Entry & System Updates

• Enter provider credentialing applications into Salesforce.
• Review daily and weekly reports to identify and update missing information.
• Maintain accurate records in Salesforce and ensure data integrity.

Provider Communication

• Email providers to gather missing credentialing information or to schedule site visits.
• Follow up with providers for updates or to complete credentialing requirements.

Reporting & Compliance

• Review weekly termination in process reports and compare with QNXT for credentialing updates.
• Process initial and recredentialing applications while meeting departmental quality and timeliness standards.
• Monitor compliance with NCQA, CMS, and company credentialing criteria.

Qualifications

Must-Have Skills

• Proven data entry experience with a focus on accuracy and speed.
• Competence with technology, including proficiency in Salesforce or similar CRM systems.
• Strong written and verbal communication skills.

Preferred Skills

• Knowledge of NCQA, CMS, and Molina credentialing criteria is a plus.
• Ability to multi-task and adapt to a rapidly changing environment.
• Familiarity with credentialing processes or systems like CACTUS is advantageous but not required.

Required Education

• High School Diploma or equivalent.

Required Experience

• 0-2 years of relevant experience in credentialing, data entry, or administrative roles.

Licensure/Certification

• No certification required.

Day-to-Day Responsibilities

• Perform data entry of credentialing applications and updates into Salesforce.
• Communicate with providers via email to gather or confirm information.
• Ensure all tasks are completed in compliance with HIPAA and company policies.

Summary
This is a remote, temp-to-perm position with the opportunity to transition to a permanent role based on performance. Ideal candidates will thrive in an organized, detail-oriented environment and be committed to supporting the credentialing process to ensure compliance and operational excellence.

Salary : $22