CREDENTIALING SPECIALIST

Credentialing Specialist

The Credentialing Specialist will perform provider Initial Credentialing, Recredentialing and/or Ongoing Monitoring including, but not limited to provider calls, primary source verifications, analysis, and independent evaluation that meets Priority Health policy and procedures, criteria, state, NCQA Accreditation and CMS standards. Savvy internet skills are required in order to perform online verifications.

Accurate provider data entry and document storage into Priority Health systems is required. Microsoft Office experience required. In addition, the Credentialing Specialist will work on other provider data management and credentialing projects as assigned. Excellent communication and time management skills are a must in order to meet tight deadlines and productivity goals.