CrawlJobs Logo
Robert Half Logo Robert Half · Health and Beauty

Sr Credentialing Representative

United States, Las Vegas Employment contract · Job Posted June 16, 2026
Apply Position
Job Link Share

Job Description

We are looking for an experienced Sr Credentialing Representative to support provider enrollment and credentialing operations. The Sr Credentialing Representative role focuses on ensuring practitioner files are accurate, current, and compliant while coordinating submissions to commercial and government payers. The ideal Sr Credentialing Representative brings strong attention to detail, knowledge of credentialing standards, and the ability to manage high-volume documentation with precision.

Job Responsibility

  • Prepare and submit initial credentialing and recredentialing applications for providers with contracted insurance payers, ensuring all records are complete and timely
  • Maintain provider licenses, certifications, and related documents by monitoring expiration dates and coordinating renewal activities
  • Update and manage CAQH profiles and other enrollment records to keep practitioner information accurate across credentialing platforms
  • Perform roster maintenance, delegation-related data entry, and payer record updates within systems such as Symplr Payer and other credentialing tools
  • Conduct primary source verification by reviewing licensing boards, certification databases, and other approved sources to confirm provider qualifications
  • Process enrollments with commercial insurers and government programs, including plans governed by applicable state and federal requirements
  • Review credentialing files for quality, completeness, and alignment with NCQA, AAAHC, Joint Commission, and internal compliance standards
  • Support hospital privilege documentation and verify related information to help maintain accurate provider participation records

Requirements

  • Previous experience in provider credentialing, payer enrollment, or healthcare data administration
  • Working knowledge of credentialing standards and regulatory requirements, including CA rules, Medi-Cal, NCQA, AAAHC, and Joint Commission expectations
  • Hands-on experience with systems such as Symplr Payer, Cactus, PECOS, MD Staff, or similar credentialing and enrollment platforms
  • Proficiency in Microsoft Excel, Word, PowerPoint, and Smartsheet for tracking, reporting, and documentation management
  • Strong understanding of CAQH maintenance, primary source verification, and provider file auditing processes
  • Ability to manage detailed data entry tasks with a high degree of accuracy and organization
  • Familiarity with hospital privileging processes and enrollment procedures for both commercial and government payers

What we offer

  • medical
  • vision
  • dental
  • life and disability insurance
  • 401(k) plan
Robert Half - All Job Offers

Looking for more opportunities?

Search for other job offers that match your skills and interests.

Suggested Tags: Frontend Developer Secretary Talent Manager Salesforce Administrator Data Analyst
Similar Jobs for

Sr Credentialing Representative

8 matching positions

Sr. Practice Manager

As a community, the University of Rochester is defined by a deep commitment to M...
Location
Location
United States of America , Rochester
Salary
Salary:
28.50 - 37.06 USD / Hour
urmc.rochester.edu Logo
University of Rochester
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Associate's degree preferably with coursework in business administration or health care administration required
  • 3 years administrative experience required
  • 2 years management experience in healthcare or an equivalent combination of education and experience
  • Electronic Medical Record (EMR) skills with expert proficiency in all aspects, including Master Scheduling and Billing knowledge required
  • Advanced knowledge of medical practices, terminology, and reimbursement policies required
  • Intermediate Microsoft Outlook email skills (open new, to, cc, send) required
  • Intermediate electronic filing skills (name a file, save file, save as) required
  • Advanced typing skills required
  • Advanced proficiency with Microsoft Word and Excel required
  • Travel to office sites required
Job Responsibility
Job Responsibility
  • Oversees the operational components of the 7 procedure rooms in the Cardiac Catheterization and Electrophysiology Lab and the 17 exam rooms in the Paul Yu Heart Center
  • In conjunction with clinical leadership, promotes operational efficiency, high quality, outstanding patient experience, and strong financial performance
  • Directs staff using the ICARE framework, promoting a collaborative, diverse, and professional team
  • Responsible for performance management of all non-clinical staff in the practice
  • Operations Management: Supervises the operation and implement procedures for enhancing levels of service and quality and enforces medical office policies and procedures for the Cardiac Cath and EP Lab and the Paul Yu Heart Center
  • Develop guidelines for prioritizing and assigning work activities, evaluating effectiveness and modifying processes as necessary
  • Establishes and maintains efficient and responsive patient flow system
  • Ensure proper registration and insurance pre-verification management processes are followed including warm transfers to centralized functions
  • Manages insurance prior authorization for procedures scheduled in the lab
  • Manages the hospital transfers from area hospitals to the lab and back to transferring hospital
  • Fulltime
Read More
Arrow Right

Sr Solution Architect

Do you enjoy solving problems, looking at problems through a different lens, and...
Location
Location
United Kingdom , Multiple Locations
Salary
Salary:
Not provided
https://www.microsoft.com/ Logo
Microsoft Corporation
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Proven success and expertise in architecting innovative solutions primarily in a client-facing role
  • Ability to quickly build relationships and credibility with customers
  • Ability to build trust to drive change with customers
  • Track record of delivering quality solutions as a technical leader
  • Executes recognized Architectural methods, processes and tools
  • A passion for learning about and experimenting with new technologies
  • Confidence in creating and delivering technical presentations and training
  • Excellent organization and planning skills
  • Bachelor’s degree relevant to Information Technology/Computer Science, Engineering (or equivalent)
  • Technical knowledge of Microsoft security and identity technologies, such as Active Directory, Azure Active Directory, Microsoft Defender, Azure, Azure Security Center, and Sentinel
Job Responsibility
Job Responsibility
  • Business to Technology Strategy: Articulating value propositions for the most strategic Microsoft products and services
  • Actively and insightfully listen to translate and articulate customer challenges and translate these to business objectives and project outcomes
  • Support the sales process and provide input on contract, staffing, assumptions and risks
  • Quantify she needs of the business to achieve value outcomes, champion required methodology, capture/reuse IP and share best practices
  • Demonstrate ability to match technical solutions with customer business requirements
  • Technology Delivery Management: Strong leadership of Technical Delivery teams, driving high performance and collaboration in complex matrix environments
  • Demonstrate an understanding of and champions Customer/Partner Change management and adoption principles
  • Own Delivery Excellence
  • Demonstrate expertise in chosen field, drive opportunities to accelerate the adoption of the Microsoft Cloud
  • Drive and support innovation focusing on industry solutions and customer business outcomes on the Microsoft platform
  • Fulltime
Read More
Arrow Right

Superintendent

ICON is seeking a Superintendent to be the on-site field leader for large scale ...
Location
Location
United States , Miami
Salary
Salary:
Not provided
iconbuild.com Logo
ICON
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 5+ years of Superintendent or field leadership experience on construction projects (commercial or residential)
  • Strong knowledge of field sequencing, site logistics, and construction means and methods
  • Familiarity working in Procore, P6, and typical field documentation tools
  • Strong communication skills
  • capable of interacting with government inspectors and installation personnel
Job Responsibility
Job Responsibility
  • Direct all daily jobsite operations, including oversight of subcontractors, ICON field staff, equipment, deliveries, and sequencing
  • Oversee all (or assigned) trade partners to ensure compliance with safety, sequencing, and workmanship standards
  • Implement and maintain the site logistics plan developed by the Sr. CM, including access control, staging, material flow, and phasing
  • Conduct daily field walks to verify progress, resolve issues, and ensure work adheres to approved drawings, submittals, and specifications
  • Prepare and maintain 2-week lookahead schedules and coordinate updates with the Sr. CM for integration into the Integrated Master Schedule (IMS)
  • Coordinate with base personnel and government representatives on inspections, escorts, access, and field activities
  • Enforce the Site-Specific Safety & Health Plan (SSHP) per OSHA
  • conduct daily safety briefings, inspections, and toolbox talks
  • Enforce security compliance, including restricted-area access control and verification of personnel credentials
  • Address safety deficiencies immediately and document corrective actions
  • Fulltime
Read More
Arrow Right

Superintendent II, MILCON

ICON is seeking a Superintendent to be the on-site field leader for Military Con...
Location
Location
United States , Austin
Salary
Salary:
Not provided
iconbuild.com Logo
ICON
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 5+ years of Superintendent or field leadership experience on DoD, USACE, NAVFAC, or large commercial projects
  • Strong knowledge of field sequencing, site logistics, and construction means and methods
  • Familiarity with: UFC / UFGS requirements, EM 385-1-1, USACE/NAVFAC QC programs, FAR/DFARS basics relevant to field execution, AT/FP standards and base-access procedures
  • Familiarity working in Procore, P6, and typical field documentation tools
  • Strong communication skills
  • capable of interacting with government inspectors and installation personnel
  • Secret clearance eligibility
  • Willingness to work at remote or secure sites with extended travel
Job Responsibility
Job Responsibility
  • Direct all daily jobsite operations, including oversight of subcontractors, ICON field staff, equipment, deliveries, and sequencing
  • Oversee all (or assigned) trade partners to ensure compliance with safety, sequencing, and workmanship standards
  • Implement and maintain the site logistics plan developed by the Sr. CM, including access control, staging, material flow, and phasing
  • Conduct daily field walks to verify progress, resolve issues, and ensure work adheres to approved drawings, submittals, specifications, and UFC/UFGS requirements
  • Prepare and maintain 2-week lookahead schedules and coordinate updates with the Sr. CM for integration into the Integrated Master Schedule (IMS)
  • Coordinate with base personnel and government representatives on inspections, escorts, access, and field activities
  • Enforce the Site-Specific Safety & Health Plan (SSHP) per EM 385-1-1
  • conduct daily safety briefings, inspections, and toolbox talks
  • Enforce security compliance, including restricted-area access control and verification of personnel credentials
  • Address safety deficiencies immediately and document corrective actions
Read More
Arrow Right
New

RN Pcu/Stepdown

Job Type: Travel Start Date: 2026-06-22 End Date: 2026-10-24 Weekly Pay: $2,832....
Location
Location
United States , Albany
Salary
Salary:
Not provided
Wellspring Nurse Source
Expiration Date
October 24, 2026
Flip Icon
Requirements
Requirements
  • Minimum 2 years of experience required
  • COVID Vaccine – Required
  • ACLS, BLS – AHA Required
  • NIHSS Required
Job Responsibility
Job Responsibility
  • Assesses the physical, psychosocial, and educational needs of the patient
  • Plans and implements nursing care according to patient and family needs
  • Makes appropriate interventions based upon individual patient needs
  • Evaluates patient responses to nursing interventions
  • Assumes personal responsibility for quality patient care, patient satisfaction, environment, and professional development
  • Fulltime
Read More
Arrow Right
New

Yard Sales Assistant

We’re looking for a full-time Yard Sales Assistant to join our Torquay branch. Y...
Location
Location
United Kingdom , Torquay
Salary
Salary:
Not provided
crsbuildingsupplies.co.uk Logo
CRS Building Supplies
Expiration Date
July 08, 2026
Flip Icon
Requirements
Requirements
  • Yard or warehouse experience (preferred)
  • Experience loading/unloading goods (advantageous)
  • Counterbalance forklift licence (advantageous)
  • Builders' merchant experience (a plus)
  • Strong customer service and communication skills
  • Positive, self-motivated attitude
  • Team player who can also work independently
Job Responsibility
Job Responsibility
  • Handle and maintain yard stock
  • Load & unload customer, supplier, and company vehicles
  • Serve customers and advise on products and availability
  • Keep the yard clean, safe, and organised
  • Follow Health & Safety standards at all times
What we offer
What we offer
  • Competitive salary
  • Pension & paid holidays
  • Supportive team environment
  • Training and career development
  • Staff discount on materials
  • Employee Assistance Programme
  • Retail discounts (Perks membership)
  • Branded uniform
  • Fulltime
Read More
Arrow Right
New

Data Engineer

We are looking for a Data Engineer to join a growing financial services organiza...
Location
Location
United States , Chicago
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 7-8 years of experience in data engineering or a closely related field
  • Strong hands-on background in building and supporting ETL or data pipeline solutions
  • Proven experience working with Snowflake in a production environment
  • Proficiency in Python for scripting, automation, and data processing tasks
  • Familiarity with modern cloud platforms
  • Experience with data ingestion technologies such as Fivetran or similar platforms
  • Ability to work through imperfect or incomplete data while communicating clearly with technical and business partners
Job Responsibility
Job Responsibility
  • Design and support data workflows that collect, refine, and deliver information across a contemporary cloud ecosystem
  • Develop and enhance scalable data pipelines using Python and automated ingestion platforms such as Fivetran or comparable tools
  • Model and transform datasets within Snowflake to enable reliable analytics and downstream business intelligence reporting
  • Collaborate closely with the data architect to expand and improve the organization’s overall data infrastructure
  • Contribute to reporting readiness by preparing curated datasets for visualization tools including Power BI and Sigma
  • Monitor pipeline performance and resolve data issues to maintain accuracy, consistency, and dependable delivery
  • Assess emerging technologies and recommend practical additions to the data stack as business needs evolve
  • Work effectively in a fast-paced team environment where priorities can shift and new tooling may be introduced regularly
What we offer
What we offer
  • medical
  • vision
  • dental
  • life and disability insurance
  • 401(k) plan
Read More
Arrow Right
New

Operations Manager

As an Operations Manager at ABC, you will take the helm of an ABC facility, crea...
Location
Location
United States , North Tucson
Salary
Salary:
65000.00 - 85000.00 USD / Year
actionbehavior.com Logo
Action Behavior Centers
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Leadership Experience: 6+ years of managing large teams across multiple sites or districts.
  • Education: A bachelor's or master's degree is preferred, but extensive management experience is equally valued. High School Diploma or GED required.
  • High Emotional Intelligence: You'll be working closely with children and families, so empathy and understanding are key.
  • Strong Communication Skills: Collaborate effectively with department leaders and teammates.
  • Impact-Driven Mindset: A proactive problem solver who thrives in high-stakes situations and is committed to delivering excellence.
  • Ability to sit, stand, and walk, as well as assume various positions such as bending, kneeling, squatting, crawling, crouching, climbing, carrying, pushing, pulling, and reaching at or above shoulder level, including overhead.
  • Capability to lift or move objects weighing up to 50 pounds.
  • Ability to maintain both near and far visual acuity.
  • Must be physically present at the assigned job location as required.
  • Proficiency in properly wearing and utilizing necessary personal protective equipment (PPE).
Job Responsibility
Job Responsibility
  • Drive operational success by managing KPIs, clinic budgets, and team performance.
  • Lead, engage, and retain a team of 25–50 professionals delivering exceptional clinical care. Support teammates through evaluations, corrective actions, development plans, and team celebrations.
  • Build trust with families by providing education and guidance during the onboarding journey.
  • Collaborate with Clinic Admissions Associates, Clinical Directors, and department leaders to ensure quality operations.
What we offer
What we offer
  • Performance Bonus: Up to $18,000 annually through monthly and quarterly incentives
  • Career Growth: Clear pathways for advancement: OM → Senior OM → Group OM → Regional Director of Operations → Senior RDO
  • Continuous Learning: Professional development through our Badge Up Program, Regional Workshops, Annual Leadership Summit, and immersive Initial Training in Austin, TX
  • PTO & Holidays: 10 days PTO, 10 paid holidays, and 2 flex days (more with tenure)
  • Student Loan Support: Up to $600 in repayment options and tuition discounts
  • Parental Perks: Maternity/paternity award of up to $3,000 and FSA options for childcare
  • Wellness Support: 90% health insurance coverage, 401k with 2% company matching, and DoorDash Pass for convenience
  • Celebrations & Connection: Team happy hours, regional recognition nights, and more
  • Fulltime
Read More
Arrow Right