Credentialing Audit Supervisor
RemoteUnited States
Job Summary
Perform quality audits and routine reviews of credentialing files to ensure accuracy, completeness, and compliance with internal policies and regulatory requirements. Identify trends, errors, and process gaps through ongoing quality assurance activities, then support internal and external audits by gathering documentation, preparing responses, and coordinating corrective action plans. Track these plans, prepare audit summaries and reports for stakeholders, and develop tools, workflows, and standard operating procedures to enhance quality and audit readiness. Partner with leadership and cross-functional teams to resolve credentialing issues and monitor adherence to standards. Requires 3+ years in NEMT credentialing, Bachelor's degree, and advanced Excel proficiency.
Required Qualifications
- Bachelor's degree or equivalent experience in healthcare operations, credentialing, quality assurance, compliance, or a related field
- 3+ years of experience in transportation provider credentialing (non-negotiable requirement)
- 3+ years of experience with provider data, quality assurance, auditing, or related functions
- Experience in Non-Emergency Medical Transportation (NEMT) credentialing or a related healthcare field
- Working knowledge of credentialing workflows, file documentation standards, and compliance expectations
- Experience supporting audits, quality reviews, or monitoring activities
- Strong organizational, analytical, and problem-solving skills
- Excellent written and verbal communication skills
- Advanced Excel (pivot tables, v-lookups, etc.) and proficiency with Adobe for reporting and documentation
- High attention to detail and ability to manage multiple priorities
- Ability to work independently and collaboratively in a fast-paced environment
Desired Qualifications
- Experience managing or tracking corrective action plans
- Prior experience preparing materials for audits or compliance reviews
- Familiarity with credentialing or workflow systems
- Experience working in a high-growth or rapidly evolving environment
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