Credentialing Representative

Location: Remote work from Pennsylvania, United States

Company

hirify.global operates healthcare-related provider and credentialing functions.

What you will do

• Process initial credentialing and re-credentialing applications, including reviewing documents, requesting missing information, and coordinating verifications.
• Load providers into appropriate networks and maintain accurate provider and dental provider file data.
• Manage credentialing inventories, reports, projects, deadlines, and complex or unusual credentialing issues.
• Support audits, business partners, internal departments, external clients, and customer-specific compliance requirements.
• Research documentation, investigate interim license actions when required, and act as a subject matter expert.
• Help streamline, automate, and enhance credentialing functions; train credentialing personnel depending on level.

Requirements

• High school diploma or GED.
• 3–5 years of related progressive experience.
• Experience in provider data management, customer service, or claims.
• Microsoft Office experience, including Word, Excel, and PowerPoint.
• Strong written and verbal communication, presentation skills, diplomacy, and professional demeanor.
• Ability to work remotely from Pennsylvania, United States.

Nice to have

• Familiarity with credentialing processes and URAC standards.
• Experience with ULTRA and Dental Provider File systems.
• Experience with customer service inquiry systems or claims processing concepts.

Culture & Benefits

• Remote work arrangement.
• No travel is required.
• The role requires compliance with HIPAA, data security guidelines, company policies, and applicable laws.