BASIC JOB PURPOSE: Under the supervision of the Credentialing Supervisor, the Credentialing Specialist is responsible for managing vendor, driver, vehicle, and insurance credentialing to ensure compliance with company, broker, and regulatory requirements. This role also ensures that all staff and transportation providers meet the necessary qualifications and credentials to provide safe, reliable services to members. The primary responsibility of this role is to manage the credentialing process, maintain compliance with relevant regulations and standards, and support the organization’s commitment to patient safety and quality care. This role requires strong attention to detail, consistent follow-up, and clear communication with vendors and internal teams.

RESPONSIBILITES/DUTIES:

1. Reviews credentialing files, utilizes reports, and works with transportation providers to obtain missing, incomplete, and expiring items.
2. Verifies provider documentation, ensures compliance with contract requirements and uploads all approved documents into CTC Connect.
3. Monitors license and credential expiration dates and advises transportation providers of required “renew by” dates.
4. Ensures that drivers and vehicles meet Call the Car, state, and health plan requirements.
5. Collects, reviews, and verifies credentialing documentation for transportation vendors, drivers, insurances, and vehicles prior to approval.
6. Ensures all required documents are current and compliant, including driver licenses, vehicle registrations, inspections, insurance, and permits.
7. Establishes and maintains strong working relationships with Call the Car employees, transportation providers, and other stakeholders.
8. Ensure accurate and timely data input.
9. Maintains consistent contact with transportation providers to ensure that expectations are clear and requirements are completed in a timely manner.
10. Performs routine audits of rideshare vendors, including monthly insurance audits.
11. Makes observations and recommendations for improvements to management.
12. Maintains clear communication between Providers, Drivers, and CTC Management.
13. Maintains a high level of accuracy with all aspects of the position.
14. Monitors, processes, and responds to emails in the Credentialing inbox in a timely manner.
15. Performs all other duties assigned by management.

PERFORMANCE REQUIREMENTS:

Knowledge, skills and abilities:

1. At least 2+ years of Customer Service experience.
2. High School Diploma required.
3. Must pass a Criminal Background Screening.
4. Must pass government exclusion list at time of hire and monthly thereafter.
5. Excellent written and verbal communication skills.
6. Basic experience using PC software programs including Microsoft Office Suite (Word, Excel, Outlook, etc.).
7. Ability to work independently or with a team.
8. Strong attention to detail along with the ability to plan and organize well.
9. Able to type at least 40 wpm.

TYPICAL WORKING CONDITIONS: The typical working condition for this position is on-site in an indoor office environment with controlled climate, lighting, and noise levels. The job may require extended periods of sitting, standing, kneeling, bending, and/or lifting of at least 25 lbs. This is an on-site position. Employees are expected to work from the office during scheduled business hours. Remote work is not available for this role. The use of a computer or other office equipment is also a requirement. Some evening, weekend, and/or holiday work and light travel may be necessary.