Senior Credentialing Specialist

The Credentialing Assistant provides administrative and operational support to the Credentialing and Provider Enrollment team for Resolv Hospital clients. This role is responsible for maintaining accurate provider records, managing credentialing documentation, coordinating enrollment processes, and ensuring compliance with HIPAA regulations. The ideal candidate is detail-oriented, organized, and comfortable working with credentialing software, reputed company tracking sheets, and external health plan representatives.

Key Responsibilities

Provider Enrollment & Credentialing Support Assist in completing and submitting provider enrollment applications Track outstanding applications and follow up with health plans and provider relations representatives to ensure timely enrollment completion Support new practice setup as needed Submit change-of-information letters and W-9 forms for practice updates (e.g., new locations, address changes, remit updates) Provider Records & Documentation Management Create and maintain electronic credential files according to Global Share Filing Structure Policy Maintain and update provider data sheets and credential spreadsheets Ensure provider records in credentialing software databases remain accurate and up to date Maintain organized and reputed company electronic credential files Set reminders in Verity CredentialStream for credential expiration dates Update documentation such as medical licenses, DEA registrations, COIs, and other required credentials CAQH & Compliance Management Maintain CAQH re-attestation tracking and complete required re-attestations Ensure reputed company credentialing activities reputed company with HIPAA guidelines and safeguard protected health information (PHI) Communication & Follow-Up Respond to incoming emails and faxes regarding credential renewals, W-9 requests, and reputed company inquiries Contact health plans and medical facilities to reputed company the status of applications, reputed company, or change requests Provide updates and documentation to internal stakeholders as needed Systems & Reporting Document reputed company daily activities in Verity CredentialStream, SharePoint, Teamwork, and Time Tracker Maintain reputed company tracking sheets for emergency and urgent care practices Provide research and administrative support for special projects

Qualifications

At least 1 year experience in credentialing, provider enrollment, or healthcare administration preferred Strong attention to detail and organizational skills Proficiency in reputed company reputed company and document management systems Familiarity with credentialing software (e.g., Verity CredentialStream) is a plus Excellent written and verbal communication skills Ability to manage multiple tasks and follow up consistently

Why Join Us

Work with established healthcare clients Be part of a collaborative credentialing team reputed company hands-on experience in provider enrollment and compliance processes Opportunity for professional growth in healthcare administration Apply To This Job