What are the responsibilities and job description for the Credentialing Analyst position at elevancehealth?
Job ID: JP46912
Anticipated Start Date: Oct 14, 2026
Please note this is the target date and is subject to change. BCForward will send official notice ahead of a confirmed start date.
Primary duties may include, but are not limited to:
Performs credentials file audits to ensure timeliness of processing, quality of documentation, and adherence to company and department policies.
Performs quality review of files to determine accuracy and completeness of all necessary documentation for Medical Director and Credentials Committee.
Analyzes performance data to predetermined standards.
May also perform site visits of provider offices for participation in networks.
Interacts with physicians, office managers, credentialing staff from other organizations to obtain information, provide status updates, research issues necessary for Credentials Committee review.
Utilizes internal systems and runs reports/queries to research provider questions and resolve issues.
Monitors license actions, complaints, and sanctions and obtains necessary information for Managers review.
Prepares documentation for Medical Directors consideration of off-cycle review.
Maintains provider peer review information on the credentialing database system.
Supports and tracks provider appeals process.
May assume responsibility for delegation oversight activities.
Participates in accreditation survey preparation via data entry, reporting, and acting as task force liaison.
Requirements:
Requires a H.S. diploma or equivalent and minimum of 3 years experience in a managed care environment; or any combination of education and experience, which would provide an equivalent background.
Strongly preferred certified Provider Credentialing Specialist and college course work.
Job Type: Contract
Additional Details:
9a-5p CT; up to 20hrs per week and may increase over time.
Virtual, work from home
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, contractors are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must be within a reasonable commute to a PulsePoint location.
About BCForward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.
BCForward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.
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This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.