Hiring: Provider Credentialing Rep Company: TriWest Healthcare Alliance Location: Phoenix, AZ Job Posted Time: 2026-09-03 14:41:03 Employment Type: Contract / Remote Target Skills & Keywords : Credentialing, Microsoft Excel, Microsoft PowerPoint About the job Experience: •2+ years of provider credentialing experience •2+ years of experience working with credentialing applications and provider data management systems to support end-to-end credentialing and data workflows •Solid functional working knowledge of URAC and/or NCQA standards, as well as VA, TRICARE, or other federal program requirements •If supporting TRICARE contract, must be a U.S. Citizen •If supporting TRICARE contract, must be able to receive a favorable interim and adjudicated final Department of Defense (DoD) background investigation Required Skills: •Ensures credentialing and certification activities adhere to regulatory requirements, accreditation criteria, federal program guidelines, and internal quality standards. •Leads the review and evaluation of certification and credentialing processes to identify gaps, redundancies, and improvement opportunities; recommend and support implementation of process enhancements aligned with organizational policies and accreditation standards. •Serves as an internal resource and subject-matter expert on credentialing policies, workflows, systems, and best practices; provides guidance to team members and cross-functional partners as needed. •Manages the credentialing shared inbox, ensuring triage, prioritization, and resolution of incoming requests, inquiries, and escalations within established service-level expectations. •Monitors, tracks, and reports on certification and credentialing escalations to ensure timely, accurate, and compliant resolution; initiates follow-up actions and coordinates cross-functional support as needed. •Facilitates and coordinates meetings with internal departments and external stakeholders to address certification and credentialing issues, concerns, or process dependencies; documents outcomes and drives execution of agreed-upon action items. •Supports the development, review, and ongoing maintenance of provider communication materials, including notices, guides, templates, and FAQs, to ensure accuracy, clarity, and alignment with current certification and credentialing requirements and organizational expectations. •Assists in developing, compiling, and distributing routine and ad hoc reports on certification and credentialing metrics, KPIs, backlog trends, workflow timeliness, and quality indicators; contributes to presenting findings to leadership and recommending improvement strategies. Qualifications: •3+ years of provider credentialing experience •3+ years of experience working with credentialing applications and provider data management systems to support end-to-end credentialing and data workflows •High School Diploma or GED Compensation: •$44,000 - $52,000 / year •Medical, Dental and Vision Coverage Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!