Job Summary

The Credentialing Analyst supports the Credentialing Team by managing day-to-day Credentialing workflows and leading data analysis projects. This role partners with Credentialing Leadership to identify workflow gaps, track performance metrics, and develop reporting for cross-functional stakeholders on the status of payor enrollment and credentialing activities.

Key Responsibilities

Workflow & Process Improvement

• Conduct routine audits of Monday.com task boards to surface performance trends and workflow gaps for leadership review.

• Partner with the Credentialing Team to develop and maintain workflow Standard Operating Procedures (SOPs) for leadership review and approval.

• Triage incoming chatbot inquiries and escalate to the appropriate Credentialing team member in a timely manner.

• Track and log incoming mail correspondence into the appropriate Monday.com project boards.

• Monitor shared credentialing inboxes ([email protected], [email protected], [email protected]) and create corresponding tasks in Monday.com, ensuring accurate routing and timely follow-up.

• Manage credentialing request form intake and route submissions to the appropriate Government or Commercial workflow queues.

Data Analysis & Reporting

• Analyze dashboards to identify trends in claim volume and reimbursement, and provide actionable insights to support payer credentialing prioritization decisions.

• Develop and distribute reporting for cross-functional teams on the status of payer enrollment and credentialing activities.

Qualifications

Education

• Bachelor's degree in Business Administration, Healthcare Administration, or a related field; equivalent work experience will be considered.

Experience

• 5 plus years of experience in healthcare credentialing healthcare, credentialing, payer enrollment, or revenue cycle experience preferred.

• Demonstrated experience with workflow management, process documentation, and cross-functional collaboration.

• Proven track record of producing accurate and actionable data analysis.

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Core Competencies

• Exceptional problem-solving skills with the ability to think strategically and execute operational initiatives.

• Strong written and verbal communication skills, with the ability to effectively manage cross-functional relationships.

• High attention to detail and organizational skills with the ability to manage multiple priorities in a fast-paced environment.

• Self-directed and proactive, with a continuous improvement mindset.

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Technical Proficiency

• Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)

• Google Workspace (Docs, Sheets, Drive, Gmail)

• Power BI or equivalent business intelligence/data visualization tools

• Project management platforms (Monday.com, Smartsheet, or equivalent)

• Familiarity with AI productivity tools (e.g., Claude AI) a plus