Remote Medical Credentialing Jobs in Springfield, MO

Job Title: Managed Care Credentialing Representative II
Location: Remote
Department: Managed Care
Employment Type: Full-time

Job Summary:

If you're energized by helping healthcare providers succeed and enjoy being the guiding force behind smooth, compliant onboarding experiences, this role is for you. As a Managed Care Credentialing Representative II, you'll play a critical role in supporting providers as they join and grow within our network-ensuring their journey from application to credentialing is seamless, accurate, and supportive. You'll join a compassionate, collaborative team committed to accuracy, trust, and improving access to quality care, while making a meaningful difference for both providers and the communities they serve.

In this role, you'll partner closely with providers to navigate credentialing and enrollment processes, manage and maintain detailed application files, and ensure all work aligns with regulatory standards. You'll leverage your attention to detail, organization, and customer-focused approach to support initial credentialing and timely recredentialing efforts, while maintaining complete and compliant records throughout the process.

This position offers...
Employee Assistance Program- 24/7 counseling services, legal assistance, & financial consultation for you and your household at no cost
Mileage Reimbursement - Company paid for work functions requiring travel
Employee Discounts - Hotels, Theme Parks & Attractions, College Tuition
Workplace Culture- An environment cultivating employee wellbeing, valuing each individual's humanity, and actively promoting a healthy, joyful workforce
Additional Perks & Benefits- Scroll down to bottom of this post to learn more

Key Responsibilities:
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

Education, Experience, and/or Credential Qualifications:
High school diploma, GED, or equivalent required
Previous healthcare credentialing experience required
Experience in healthcare administration utilizing advanced Microsoft Office tools, including Excel, preferred

Additional Qualifications:
Excellent customer service, communication (oral and written), and time management skills
Strong organizational skills with exceptional attention to detail
Analytical ability to research industry policies and translate findings into actionable steps
Ability to manage multiple projects concurrently while meeting varying deadlines
Current driver's license, acceptable driving record, and current auto insurance required
Successful completion of required background screenings, including criminal history and abuse/neglect checks

Physical Requirements
Perform sedentary work, exerting up to 10 pounds of force occasionally and negligible force frequently
Engage in repetitive hand, finger, and arm movements for typing and writing throughout the workday
Sit for extended periods with occasional walking or standing as needed

Keywords: healthcare credentialing, provider onboarding, managed care, healthcare administration, credentialing specialist, provider enrollment, compliance, medical credentialing, healthcare operations