Job Description
We are seeking a highly organized and detail-oriented Credentialing Specialist to support new provider onboarding, current provider recredentialing, and compliance activities. This role plays a key part in maintaining accurate provider records and preparing for future audits. The ideal candidate is a quick learner, has good communication skills, and has a strong background in healthcare credentialing. Daily responsibilities include but are not limited to:
Process provider applications, including background checks, document uploads, and tracking logs.
Review and compile credentialing documents for new and existing providers.
Maintain and update provider files, listings, and credentialing databases.
Run weekly reports and assist with health plan audits.
Support Membership and Credentialing Committees with documentation and provider status updates.
Maintain a comprehensive credentialing database, which can generate reports useful to the organization as a whole.
Ensure that all provider licensure, certification, hospital privileges, insurance coverage, and other documents are active, within policy guidelines, and up to date.
Accurately record the addition of new providers, deletion of terminated providers, and provider information changes.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Required Skills & Experience
-3+ yrs of experience with credentialing or auditing large amounts of data/paperwork
-Experience supporting health plan, health insurance company, or independent physician association
-Prior healthcare experience
-Strong attention to detail
Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.