Managed Care Credentialing Representative II

Guide onboarding providers through credentialing application and enrollment processes, answering questions and providing clear, supportive direction. Complete initial credentialing and recredentialing applications while proactively monitoring progress and following up to meet required timelines. Compile, verify, and maintain accurate provider data within credentialing databases and files. Investigate and document practitioner credentials, including education, training, licensure, and professional history, in accordance with regulatory standards. Communicate adverse or questionable verification findings to supervisors and leadership as needed. Assist providers with changes to privileges or license types. Maintain departmental standards while ensuring compliance with all applicable credentialing regulations. Perform other related duties as assigned.