Credentialing Specialist

BCforward is currently seeking a highly motivated Credentialing Specialist for an opportunity in Remote - FL!

Position Title: Credentialing Specialist

Location: Remote - FL

Anticipated Start Date: 04/01/2025

Please note this is the target date and it is subject to change. BCforward will send official notice ahead of a confirmed start date.

Expected Duration: 6+ Months of contract with possible extension

Job Type: [FULL TIME (>%3D30 HRS WEEKLY], [CONTRACT], [Remote]

Pay Range: $25.00 - $28.00/hr.

Please note that actual compensation may vary within this range due to factors such as location, experience, and job responsibilities, and does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).

Requirements:

• NAMSS Credentialing Certification, knowledge of NCQA Standards.

Job Description:

Summary:

The Credentialing Specialist is responsible for credentialing individual, facility and/or ancillary medical/surgical providers to ensure all credentialing standards and internal requirements are met and maintained.

Job Responsibilities:

The online webform submissions generate an email that is received in a shared mailbox.

Each credentialer has a folder with their name on it and the emails are assigned to those folders.

We have a team chat for anyone on the team to ask questions.

The idea is for the emails assigned to be worked from oldest to newest, they will create a practitioner folder in our S Drive where all the documents will be gathered and saved.

If they can complete the process, the request is submitted through our internal system and a communication to the provider is sent letting them know the process was completed.

Missing information is tracked in our SharePoint.

Verifies and maintains all network, individual and/or facility/ancillary providers information.

Monitors disciplinary actions, and follows up accordingly.

Corresponds with licensing board, hospitals, certification agencies, training programs and medical groups to resolve any issues.

Ensures and maintains overall accuracy of credentialing database.

Gathers data, builds/runs reports, and sends out updates.

Corresponds with licensing board, hospitals, certification agencies, training programs and medical groups, practitioners, office staff, provider network administrators, contracting and management to resolve issues.

May review and identify credentialing or re-credentialing practitioners, including verifications of correspondence, data entry, etc., in accordance with company policies and procedures.

Reviews and analyzes reports, policies and procedures, summarizes, analyzes and makes notations in reports for feedback to groups and for distribution to management and Credentialing Committee.

Assists in the preparation of file reports and binders for monthly Credentialing Committee meetings, including pre-and post-Committee functions.

Assists on internal projects to obtain follow-up information as requested by Credentialing Committee or Peer Review Teams.

Performs other duties as assigned.

Required Education/Experience:

High school diploma.

Associate's degree in business administration, Health Care Administration or related field preferred.

0-2 years of experience.

NAMSS Credentialing Certification, knowledge of NCQA Standards.

Work under pressure, Time management and Communicational skills.

Benefits:

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

Keywords:

[NAMSS Credentialing Certification, knowledge of NCQA Standards.]

About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format to Please reference job code 236881 when responding to this ad.