Credentialing Operations Specialist - Temporary

About the role

The Credentialing Operations Specialist will support all aspects of credentialing processes for healthcare professionals and facilities, ensuring compliance with organizational, national, and contractual requirements.

Responsibilities

• Supports credentialing processes and activities to meet QUEST integration and network adequacy requirements.
• Triage and validate credentialing applications and documentation.
• Enters and updates credentialing systems and files.
• Maintains and monitors credentialing databases for daily operations.
• Communicates with providers, administrators, and staff regarding credentialing activities.
• Assists with provider relations, credentialing team, and contracts staff.
• Adheres to regulatory compliance and quality guidelines, as well as AlohaCare policies and procedures.
• Maintains confidentiality of AlohaCare’s information.

Requirements

• High school diploma or equivalent.
• Minimum of 1 year of administrative and/or clerical experience.
• Minimum of 1 year of customer service experience.
• Ability to read, analyze, and interpret business documents.
• Proficient use of Adobe products and programs.
• Strong interpersonal and facilitation skills.
• Excellent written and oral communication skills.
• Effective problem-solving and critical thinking skills.
• Strong customer service skills.
• Independent work ability.
• Time management and organizational skills.
• Working knowledge of Microsoft Office programs.
• Data entry experience with high accuracy and attention to detail.

Preferred Requirements

• Provider and Facility Health Plan credentialing experience.