Credentialing Specialist

Sagility

Credentialing Specialist responsible for provider credentialing within health plan operations. This role ensures compliance with internal standards and offers a high-quality provider experience.

Posted 7/6/2026full-timeRemote • 🇺🇸 United StatesJunior💰 $20 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider credentialing processes, including compliance with NCQA, CMS, and state standards. Strong organizational skills and attention to detail are essential for managing high-volume applications and maintaining accurate provider information.

Highest-signal resume keywords

Provider Credentialing ExperienceNCQA FamiliarityCMS KnowledgeStrong Organizational SkillsAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Credentialing Database ManagementData EntryApplication ProcessingCompliance ReportingProvider Information Maintenance

Soft Skills

Time ManagementProblem-SolvingInterpersonal CommunicationWritten CommunicationTeam Collaboration

Industry Keywords

Health Plan CredentialingProvider DemographicsDelegated Entities ManagementConfidentiality of Sensitive DataCredentialing Standards

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

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.

Benefits

Comp & perks

Medical, Dental, and Vision coverage.
Life Insurance.
Short-Term and Long-Term Disability options.
Flexible Spending Account (FSA).
Employee Assistance Program.
401(k) with employer contribution.
Paid Time Off (PTO).
Tuition Reimbursement.