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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in provider healthcare credentialing, including maintaining accurate provider data, managing enrollment applications, and ensuring compliance with state licensing and health plan requirements. Proficient in using credentialing software and Microsoft Office tools to support data management and communication.
Highest-signal resume keywords
Provider Healthcare CredentialingCredentialing Software ExperienceCPCS CertificationData AnalysisExcellent Oral Communication
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Provider Data ManagementEnrollment ApplicationsLicense TrackingCredentialing RequestsMicrosoft OutlookMicrosoft WordMicrosoft ExcelMicrosoft AccessData ResearchConfidentiality Maintenance
Soft Skills
Independent WorkCustomer ServiceRelationship Management
Certifications & Qualifications
CPCS Certification
Industry Keywords
Outpatient PTOTSPABAPediatric RehabHealth PlansState Agency Requirements
About the role
Key responsibilities & impact- Maintain current and accurate data for all providers
- Complete provider/payor enrollment applications, monitor applications, and follow up as needed
- Maintain current state licenses, malpractice coverage, and other required provider documents
- Maintain provider information in online databases such as NPI and CAQH
- Collect information from providers and coordinate with the CVO to submit credentialing requests
- Track license and certification expirations to ensure timely renewals
- Audit and ensure practice address information with health plans is listed correctly
- Maintain confidentiality of provider information
- Perform other duties as assigned
Requirements
What you’ll need- A high school diploma or GED equivalent is required
- A minimum of two years of experience in all facets of provider healthcare credentialing, with a focus on Outpatient PT/OT/SP/ABA/Pediatric Rehab
- Computer skills using Microsoft Outlook, Word, Excel and Access
- Experience using credentialing software and working with a CVO and external vendors
- Knowledge of health plans and other state agency requirements for credentialing
- Ability to research and analyze data
- Ability to work independently with minimal supervision
- Ability to maintain confidentiality of provider information
- Excellent oral communication skills and phone presence
- Understanding of quality customer service and relationship with insurance carriers and field operators
- CPCS certification preferred, but not required
Benefits
Comp & perks- Eligibility for full benefits package beginning within your first month of employment
- Generous PTO (Paid Time Off) plans
- Paid holidays
- Teamwork, growth, and serving others prioritized through company values