Assoc Client Services Rep (Credentialing Specialist/Provider Enrollment Specialist)

IQVIA•Houston, TX

3d•$37,400 - $93,600•Hybrid

About The Position

As a Client Services Representative, Credentialing at Cedar Gate Technologies, an IQVIA business, you will play a key role in supporting credentialing services for healthcare clients by maintaining accurate provider information, validating data, and resolving credentialing-related discrepancies. Serving as a trusted resource to physician practices, hospitals, and healthcare payers, you will apply your knowledge of provider credentialing processes, industry regulations, and established policies to ensure the integrity and quality of credentialing data. In this fast-paced environment, you will manage multiple priorities while meeting time-sensitive deadlines with exceptional attention to detail and accuracy. You will use sound judgment to research and resolve issues, adapt to evolving client and business needs, and contribute to the successful delivery of high-quality credentialing services. Strong organizational and customer service skills are essential, as you will build productive client relationships, deliver responsive support, and help drive client satisfaction and operational excellence. Your ability to balance precision, responsiveness, and professionalism will make you a valued contributor to both the Credentialing team and Cedar Gate's continued success.

Requirements

3+ years of credentialing experience, preferably in a delegated credentialing environment
Detail-oriented with the ability to recognize vital information from credentialing documents
Proven ability to exercise independent judgment in managing and relaying confidential information
Ability to work well under tight deadlines and respond to changing demands and provide efficient follow-up rapidly
Ability to consistently meet or exceed quality and production expectations
Proficiency in data entry and use of databases and other credentialing related databases
Professional experiences with problem-solving, critical thinking, and deductive reasoning skills
Outstanding oral, written, and interpersonal communication skills
Excellent customer service skills
To be eligible for this position, you must reside in the same country where the job is located.

Nice To Haves

NAMSS Certified Provider Credentialing Specialist (CPCS) certification preferred or working toward certification

Responsibilities

Prepare credentialing information for the client's contracted health plans, including document review and credentialing file preparation
Perform primary source verifications
Follow up with individual practitioners and internal and external entities to resolve discrepancies identified during the credentialing process
Keep the manager informed of potential credentialing issues or delays
Complete data entry of provider credentialing information into web-based provider database
Maintain an accurate database of provider credentialing information in a web-based provider database by performing routine data reconciliation
Prepare credentialing committee meeting documents for distribution, facilitate committee meetings and record meeting minutes
Complete review of scanned provider file documents in OnBase to validate document retention
Prepare and review provider application and client documents for annual payer audits
Communicate with client's payers to ensure timely receipt of provider payer effective dates
Participate in annual policies and procedures review and revision
File and maintain credentialing contract file documents
Maintain a working knowledge & application of computer directories, folders, and worksheets for filing and storing data
Respond to all practitioners, client health plans, and internal inquiries in a timely manner
Participate in team meetings and process improvement initiatives to continuously improve work product quality and efficiency