Credentialing Support Associate III

Guardian Life Insurance Company•Newport Beach, CA

1d•Remote

About The Position

Guardian is seeking a Credentialing Support Associate III to support the provider credentialing and recredentialing process by maintaining accurate provider records, coordinating provider outreach, and ensuring compliance with regulatory and organizational requirements. In this role, you will work closely with providers and internal stakeholders to validate information, resolve discrepancies, and support high-quality provider network operations.

Requirements

High school diploma or equivalent; Associate's or Bachelor's degree preferred
Experience supporting provider credentialing, healthcare operations, provider enrollment, or administrative processes
Experience maintaining and updating data within databases or business systems
Strong attention to detail and commitment to data accuracy
Excellent verbal and written communication skills
Ability to follow established processes and regulatory requirements
Strong organizational and time management skills
Ability to manage multiple priorities in a deadline-driven environment
Proficiency with Microsoft Office applications, including Excel and Outlook

Nice To Haves

Experience with provider credentialing and recredentialing processes
Familiarity with NCQA, CMS, state, or other healthcare regulatory requirements
Experience conducting primary source verification activities
Experience working with credentialing software or provider management systems
Knowledge of healthcare provider networks and credentialing standards

Responsibilities

Maintain accurate provider information by entering, updating, and auditing data within credentialing systems.
Coordinate recredentialing activities, including distributing recredentialing communications and monitoring provider responses.
Communicate with providers to obtain missing documentation, resolve discrepancies, and ensure complete credentialing files.
Conduct primary source verification activities for initial credentialing and recredentialing applications in accordance with regulatory requirements and company standards.
Track and follow up on outstanding credentialing requirements to support timely processing and compliance.
Partner with internal stakeholders to ensure provider records are accurate, complete, and compliant with organizational policies.
Support continuous improvement efforts that enhance credentialing processes and data quality.