Credentialing Specialist- Franklin, TN.

CVS Health•Franklin, TN

7d•Hybrid

About The Position

The Credentialing Specialist reviews, analyzes, and validates provider and producer information against credentialing and business requirements, and maintains accurate records in credentialing databases. The role supports research and review of provider and producer information, helps address data discrepancies and integrity issues, and escalates sensitive or complex matters when needed. It involves handling confidential information, organizing work to meet deadlines, drafting routine professional correspondence, and communicating with providers and internal colleagues under guidance. The position uses Microsoft Office applications and internet resources and follows a hybrid work model requiring three days in the Franklin, Tennessee office.

Requirements

At least 1 year of customer service experience.
At least 6 months of experience researching and analyzing data.
At least 6 months of experience using Microsoft Office applications, including Word, Excel, and Access, and internet resources.
High school diploma.
Ability to work the Franklin hybrid model, with 3 days in the office.

Nice To Haves

Associate's degree.
Ability to work independently on routine tasks.
Ability to handle confidential information reliably, prudently, and tactfully.
Ability to organize and prioritize work and manage multiple priorities.
Excellent verbal and written communication skills, including letters, memos, and emails.
Ability to establish and maintain effective working relationships with providers, management, staff, and external contacts.

Responsibilities

Review, analyze, and validate provider and producer information against credentialing and business requirements.
Maintain and update provider and producer records in credentialing databases accurately.
Research and review provider and producer information, escalating sensitive or complex issues as needed.
Identify and correct data discrepancies to support data integrity and compliance.
Handle confidential and sensitive information professionally and discreetly.
Organize and prioritize assigned tasks to meet deadlines in a fast-paced environment.
Draft and respond to basic professional correspondence, including emails and routine notices.
Communicate with providers, internal staff, and management under guidance and supervision.
Complete routine tasks independently and seek guidance for new or complex issues.
Use Microsoft Office applications and internet resources to research and maintain information.