Credentialing Specialist

Centene Corporation

. Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards .

Posted 11/5/2026full-timeRemote • United StatesJunior💰 $19 - $33 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in credentialing and re-credentialing processes in compliance with NCQA standards, along with strong communication skills to interact effectively with healthcare providers and third parties. Proficient in data entry and reporting to support business functions within a fast-paced healthcare operations environment.

Highest-signal resume keywords

CredentialingRe-CredentialingPSV For Education VerificationData EntryHealthcare Operations Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CredentialingRe-CredentialingData EntryProvider Data ManagementEducation Verification

Soft Skills

Professional CommunicationAbility To Thrive In Fast-Paced Environment

Tools & Technologies

Reporting Tools

Industry Keywords

NCQA StandardsManaged CareInsurance Environment

About the role

Key responsibilities & impact

Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards
Communicate with physicians, office managers, providers, and other third parties to secure needed information
Gather information for Credentialing Committee meetings
Process, track and file credentialing applications within established standards
Generate and utilize reporting to support business functions
Perform PSV for education verification

Requirements

What you’ll need

Associate’s degree, or high school diploma/equivalent and 1+ years of data entry, customer service, medical office, provider data management, credentialing or healthcare operations experience
Experience preferably in a managed care or insurance environment
Ability to perform PSV for education verification
Ability to thrive in a fast-paced production environment while maintaining quality
Ability to communicate professionally with physicians, office managers, providers, and other third parties
Ability to generate and utilize reporting to support business functions

Benefits

Comp & perks

Competitive pay
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation