Credentialing Specialist - Work from Home

Sagility

57d•Remote

About The Position

BroadPath, a Sagility Company, is hiring experienced Credentialing Specialists to join our remote team! Credentialing Specialists support our health plan operations by ensuring timely, accurate provider credentialing. This role is key to maintaining compliance with internal standards and external regulations while supporting a high-quality provider experience.

Requirements

1+ years of experience of provider credentialing for a health plan
Strong organizational and time management skills
Ability to meet deadlines and handle high-volume work
Able to work independently and in a team setting
Strong attention to detail and problem-solving skills
Familiarity with NCQA, CMS, and state credentialing standards
Excellent written, verbal, and interpersonal communication skills
On-camera participation during interviews, training, team meetings, and regular check-ins.
Face-to-face discussions sparking collaboration and engagement
A supportive atmosphere where you can express yourself openly and be part of a team that values your contributions.

Responsibilities

Verify provider credentials through approved sources in a timely and accurate manner
Track and process credentialing and re-credentialing applications
Enter and update provider information in the credentialing database
Maintain and update provider demographics
Monitor and manage data from delegated entities
Communicate with providers or their office staff regarding credentialing status and required documentation
Identify and report non-compliance or credentialing issues to the supervisor
Ensure confidentiality of sensitive data and documents
Perform other duties as assigned