A company is looking for a Credentialing Specialist II to perform credentialing and re-credentialing of provider applications.
Key Responsibilities:
- Process incoming applications and perform timely follow-up with providers
- Conduct primary source verification and maintain provider information in various systems
- Respond to inquiries regarding the status of provider applications and support Credentialing Specialist I
Required Qualifications:
- High School Diploma or GED required; Associate degree or CPCS certification preferred
- 3+ years of credentialing experience, preferably in a managed care setting
- Working knowledge of NCQA standards and payer credentialing standards
- Beginner Excel skills for data entry and basic formulas
- Familiarity with Symplr / Cactus software preferred
