Provider Data Maintenance, Credentialing Specialist I

USAble Life

. Conduct provider credentialing application and contract package review prior to processing .

Posted 9/22/2026full-timeJacksonville • Florida • United StatesJuniorMid-Level💰 $20 - $26 per hourWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in provider credentialing processes, including application review, contract management, and primary source verification. Strong communication and customer service skills are essential for effective interaction with providers and external agencies.

Highest-signal resume keywords

Provider CredentialingContract ManagementPrimary Source VerificationHealth Insurance Industry ExperienceAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Credentialing Application ReviewContract Package ReviewDocument PreparationData EntryInformation Extraction

Soft Skills

Excellent Communication SkillsCustomer Service SkillsAbility to Work IndependentlyTeam CoordinationTime Management

Tools & Technologies

MS Office

Industry Keywords

Health InsuranceDental InsuranceCredentialing Verification OrganizationAdverse ReportsProvider Contracts

About the role

Key responsibilities & impact

Conduct provider credentialing application and contract package review prior to processing
Enter credentialing and re-credentialing applications into administration systems
Follow up with the Credentialing Verification Organization to obtain completed Primary Source Verification credentialing reports
Communicate with providers and external agencies regarding missing or incomplete information
Review credentialing reports for accuracy
Enter contract arrangements into the administration system following credentialing
Update and maintain provider contract and demographic information for reporting, claims payment, and directory accuracy
Generate correspondence to providers regarding contract or demographic changes, credentialing status, and missing information
Meet departmental and individual productivity and quality metrics
Prepare documents for contract execution
Process adverse files and research information with appropriate agencies
Prepare adverse reports for Dental Credentialing Committee review
Conduct telephonic and written outreach to providers
Perform other related duties as assigned

Requirements

What you’ll need

Experience in the health or dental insurance industry
Excellent communication skills, including the ability to address a wide range of audiences
Customer service skills
Basic MS Office skills
Ability to read documents and extract information
Ability to understand and evaluate contractual language
Ability to work within time constraints and maintain attention to detail
Ability to prioritize workflow and work independently but coordinate efforts within a team
High school diploma or equivalent
2–4 years of related experience
Applicants must be authorized to work for any employer in the U.S.
Associate's Degree with 3 years of related experience preferred

Benefits

Comp & perks

Outstanding and affordable benefits package
PTO provided at date of hire
11 paid holidays
401(k) with up to 6% match; fully vested from day 1
Remote opportunities with company-provided equipment
Team-oriented, collaborative group of peers
Career advancement opportunities
Tuition Reimbursement
Employee Assistance Program
Inclusion Council and Employee Resource Groups
Recharge Days and Volunteer Time Off
Annual incentive plan based on company performance and individual performance