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, Excel 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 current 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 all credentialing activities comply 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 related inquiries
Contact health plans and medical facilities to check the status of applications, contracts, or change requests
Provide updates and documentation to internal stakeholders as needed
Systems & Reporting
Document all daily activities in Verity CredentialStream, SharePoint, Teamwork, and Time Tracker
Maintain Excel 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 Microsoft Excel 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
Gain hands-on experience in provider enrollment and compliance processes
Opportunity for professional growth in healthcare administration
The ideal candidate is detail-oriented, organized, and comfortable working with credentialing software, Excel 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 current 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 all credentialing activities comply 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 related inquiries
Contact health plans and medical facilities to check the status of applications, contracts, or change requests
Provide updates and documentation to internal stakeholders as needed
Systems & Reporting
Document all daily activities in Verity CredentialStream, SharePoint, Teamwork, and Time Tracker
Maintain Excel 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 Microsoft Excel 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
Gain hands-on experience in provider enrollment and compliance processes
Opportunity for professional growth in healthcare administration