Sr. Credentialing Representative

Job Description

Job Description

Job Title : Credential Representative

Job Type : W2 Contract – 12 months

Location : Minneapolis, MN (Hybrid – onsite as needed)

Schedule : M – F 8am to 5pm

Pay Rate : $ 25 – 32 / hour, DOE

Position Overview :

The Credentialing Compliance Specialist is responsible for ensuring compliance with regulatory, state, federal, accreditation, and payor requirements within the credentialing process. This role supports internal and external audits, accreditation surveys, sanction monitoring, sub-delegation oversight, reporting, and committee deliverables. The specialist will serve as a liaison during on-site audits, provide team support, and assist with projects as assigned. The ideal candidate will bring a strong background in credentialing or healthcare compliance, excellent organizational skills, and the ability to thrive in a fast-paced environment.

Key Responsibilities

• Perform ongoing monitoring of provider sanctions and prepare credentialing compliance reports.
• Conduct delegation and sub-delegation oversight of external entities to ensure regulatory compliance.
• Support internal and external audit and survey processes, including acting as an on-site liaison when required.
• Prepare deliverables and documentation for Credentialing Committee meetings.
• Provide support to the credentialing compliance team and respond to internal and external inquiries.
• Collaborate with the larger Credentialing team to meet regulatory, accreditation, and payor standards.
• Contribute to special projects and perform other duties as assigned.

Qualifications

Pride Global offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.

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