Credentialing Specialist- Franklin, TN.

CVS Health•Franklin, TN

1d•$17 - $28•Hybrid

About The Position

The Credentialing Specialist reviews, analyzes, evaluates, and validates provider and producer information against business and credentialing requirements, and maintains that information in credentialing databases. The role supports research and analysis of sensitive provider and producer issues and helps address data integrity concerns. The specialist maintains accurate records, helps identify and correct discrepancies, handles confidential information with discretion, and supports routine communications with providers and internal contacts. The role works independently on routine tasks while seeking guidance on new or complex issues, and uses Microsoft Office applications and internet resources to research and maintain information. The position follows a Franklin hybrid work model with three days in the 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.
Able to work the Franklin hybrid work model, with 3 days in the office.
Strong attention to detail.
Willingness to learn credentialing policies, procedures, and systems.

Nice To Haves

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.
Associate's degree preferred.

Responsibilities

Review, analyze, and validate provider and producer information to ensure it meets credentialing and business requirements.
Maintain and update provider and producer records in credentialing databases with a high level of accuracy.
Support research and review of 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.
Work independently on routine tasks and seek guidance for new or complex issues.
Use Microsoft Office applications and internet resources to research and maintain information.
Learn and follow credentialing policies, procedures, and systems.