Looking to advance your healthcare career from the comfort of your home? AZ Blue is seeking a Medical Credentialing Specialist to join our remote team in Arizona. As a Medical Credentialing Specialist, you will manage credentialing and recredentialing processes for BCBSAZ and TriWest Healthcare Alliance providers, ensuring all licenses, certifications, and documentation are accurate and compliant. This is an excellent opportunity for detail-oriented professionals who thrive on organization, communication, and making a meaningful impact in healthcare.
Medical Credentialing Specialist Responsibilities
As a Medical Credentialing Specialist, you will perform primary source verifications, maintain credentialing files, and prepare documentation for the Credentials Committee. You will ensure all providers meet AZ Blue and TriWest credentialing standards, organize files, and communicate effectively with physicians, facilities, and external partners.
Credentialing Compliance and Quality Assurance
You will review provider files for accuracy, perform quality control, and monitor ongoing compliance with URAC and BCBSAZ standards. This includes conducting audits, maintaining desk-level procedures, and generating reports for leadership.
Data Management and Reporting
Maintain and update credentialing databases, compile reports for the Credentials Committee, and ensure all data entry is accurate. Your work will support timely provider onboarding and ongoing compliance efforts.
Qualifications & Skills
-
High school diploma or GED required; Associate’s degree preferred for Level 2–3 roles
-
1–5 years of credentialing experience in managed care or hospital settings, depending on level
-
Familiarity with credentialing databases, office software, and standard office equipment
-
Strong analytical, organizational, and communication skills
-
Ability to maintain confidentiality and prioritize tasks effectively
Work Environment
-
Remote position within Arizona (residency required)
-
Full-time schedule, minimum 40 hours/week with potential additional hours as needed
-
Hybrid, onsite, or remote options are available for other AZ Blue roles; this role is fully remote
Equal Opportunity Commitment
AZ Blue is committed to creating a diverse and inclusive workplace. We do not discriminate based on race, ethnicity, gender, sexual orientation, age, disability, veteran status, or any other legally protected characteristic.