Credentialing Specialist

Job Description

They will be responsible for auditing and updating physician records for audits and state requirements.

Perform initial assessment and analysis of approved credentialing and re-credentialing files to determine compliance with NCQA guidelines and state regulations

Worked directly with IT to design and implement a credentialing audit tool using the SharePoint site

Drafted new and proposed updates to existing Credentialing Policies and Procedures based on NCQA guidelines and individual state regulations

Supported Director of Project Management with preparing weekly reports related to file categorization, volume, assignment to and completion by Credentialing Specialist, and quality score

Achieved marked increase in results of delegated audits, resulting from the implementation of the auditing tool

Additional Skills & Qualifications

Must have at least 1+ years within medical credentialing or a relatable healthcare role such as provider enrollment/patient accounting/customer service/etc.

Ideal if familiar with NCQA & CAQH

Ideal candidates will have hospital credentialing

Must have excellent customer service over the phone

Must have strong computer skills

Must be able to work through an excel spreadsheet/track comments next to each provider

Experience Level

Entry Level

Pay and Benefits

The pay range for this position is $21.00 - $22.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision

• Critical Illness, Accident, and Hospital

• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available

• Life Insurance (Voluntary Life & AD&D for the employee and dependents)

• Short and long-term disability

• Health Spending Account (HSA)

• Transportation benefits

• Employee Assistance Program

• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Baltimore,MD.

Application Deadline

This position is anticipated to close on May 2, 2025.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.