About this role
The Credentialing Assistant provides administrative and operational support to the Credentialing and Provider Enrollment team for Resolv Hospital clients. This role is responsible for maintaining accurate provider records, managing credentialing documentation, coordinating enrollment processes, and ensuring compliance with HIPAA regulations.The ideal candidate is detail-oriented, organized, and comfortable working with credentialing software, Excel tracking sheets, and external health plan representatives.
Key Responsibilities
Provider Enrollment & Credentialing SupportAssist in completing and submitting provider enrollment applicationsTrack outstanding applications and follow up with health plans and provider relations representatives to ensure timely enrollment completionSupport new practice setup as neededSubmit change-of-information letters and W-9 forms for practice updates (e.g., new locations, address changes, remit updates)Provider Records & Documentation ManagementCreate and maintain electronic credential files according to Global Share Filing Structure PolicyMaintain and update provider data sheets and credential spreadsheetsEnsure provider records in credentialing software databases remain accurate and up to dateMaintain organized and current electronic credential filesSet reminders in Verity CredentialStream for credential expiration datesUpdate documentation such as medical licenses, DEA registrations, COIs, and other required credentialsCAQH & Compliance ManagementMaintain CAQH re-attestation tracking and complete required re-attestationsEnsure all credentialing activities comply with HIPAA guidelines and safeguard protected health information (PHI)Communication & Follow-UpRespond to incoming emails and faxes regarding credential renewals, W-9 requests, and related inquiriesContact health plans and medical facilities to check the status of applications, contracts, or change requestsProvide updates and documentation to internal stakeholders as neededSystems & ReportingDocument all daily activities in Verity CredentialStream, SharePoint, Teamwork, and Time TrackerMaintain Excel tracking sheets for emergency and urgent care practicesProvide research and administrative support for special projects
Qualifications
At least 1 year experience in credentialing, provider enrollment, or healthcare administration preferredStrong attention to detail and organizational skillsProficiency in Microsoft Excel and document management systemsFamiliarity with credentialing software (e.g., Verity CredentialStream) is a plusExcellent written and verbal communication skillsAbility to manage multiple tasks and follow up consistently
Why Join Us
Work with established healthcare clientsBe part of a collaborative credentialing teamGain hands-on experience in provider enrollment and compliance processesOpportunity for professional growth in healthcare administrationOriginally posted on Himalayas