Credentialing Support Specialist

Job Summary

The Credentialing Support Specialist reports directly to the Credentialing Manager. The position is responsible for providing administrative and operational support to the Credentialing Team responsible for credentialing, recredentialing, and revalidation activities across commercial, governmental, and pharmacy benefit manager (PBM) payer networks. The role requires assisting with documentation, data entry, tracking, and coordination among various departments and otherwise ensuring that the credentialing team is able to timely and accurately complete credentialing processes.

Duties/Responsibilities

• Aid Credentialing Specialists with preparation of enrollment and recredentialing applications.
• Request, track, compile and organize required documentation for submission.
• Upload documents and updates in credentialing systems and tracking tools.
• Maintain organized files.
• Maintain records in systems such as NPPES, NCPDP, Availity, and internal tracking logs.
• Track key dates for renewals or revalidations and report on upcoming deadlines or missing documentation.
• Follow established policies, procedures, and workflows defined by the Credentialing team.
• Maintain close working relationships with Company senior management and franchisees.

Required Skills/Abilities

• Strong organizational and administrative skills.
• High attention to detail, particularly in document review and data entry.
• Exceptional skills in communicating orally and in writing.
• Demonstrated computer skills (Excel, Microsoft Office, PowerPoint, and Word).
• Demonstrated ability to adapt to a changing environment and handle multiple priorities.

Education and Experience

• A High School Diploma or equivalent required.
• Some experience in a healthcare administrative setting, with credentialing support preferred.

Physical Requirements

• Sitting: Prolonged periods of sitting are typical, often for the majority of the workday.
• Keyboarding: Frequent use of a keyboard for typing and data entry.
• Reaching: Occasionally reaching for items such as files, documents, or office supplies.
• Fine Motor Skills: Precise movements of the fingers and hands for tasks like typing, using a mouse, and handling paperwork.
• Visual Acuity: Good vision for reading documents, computer screens, and other detailed work.

Benefits

• Comprehensive medical, dental, and vision plans, plus flexible spending, and health savings accounts.
• Paid time off, personal days, and company-paid holidays.
• Paid Paternal Leave.
• Volunteerism Days off.
• Income protection programs include company-sponsored basic life insurance and long-term disability insurance, as well as employee-paid voluntary life, accident, critical illness, and short-term disability insurance.
• 401(k) matching and tuition reimbursement.
• Employee assistance programs include mental health, financial and legal.
• Rewards programs offered by our medical carrier.
• Professional development and growth opportunities.
• Employee Referral Program.

Pay

$45,000 - $50,000

Schedule

Full-time and remote