Job Description

Role Description

BroadPath, a Sagility Company, is hiring experienced Credentialing Specialists to join our remote team! Credentialing Specialists support our health plan operations by ensuring timely, accurate provider credentialing. This role is key to maintaining compliance with internal standards and external regulations while supporting a high-quality provider experience.

Qualifications

• 1+ years of experience of provider credentialing for a health plan
• Strong organizational and time management skills
• Ability to meet deadlines and handle high-volume work
• Able to work independently and in a team setting
• Strong attention to detail and problem-solving skills
• Familiarity with NCQA, CMS, and state credentialing standards
• Excellent written, verbal, and interpersonal communication skills

Requirements

• Verify provider credentials through approved sources in a timely and accurate manner
• Track and process credentialing and re-credentialing applications
• Enter and update provider information in the credentialing database
• Maintain and update provider demographics
• Monitor and manage data from delegated entities
• Communicate with providers or their office staff regarding credentialing status and required documentation
• Identify and report non-compliance or credentialing issues to the supervisor
• Ensure confidentiality of sensitive data and documents
• Perform other duties as assigned

Benefits

• Medical, Dental, and Vision coverage
• Life Insurance
• Short-Term and Long-Term Disability options
• Flexible Spending Account (FSA)
• Employee Assistance Program
• 401(k) with employer contribution
• Paid Time Off (PTO)
• Tuition Reimbursement

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