[Hiring] Credentialing Specialist III @Cisive

Role Description

This role is responsible for executing credentialing and licensing research, data validation, and compliance checks that support LicenseManager Pro and SanctionCheck operations. Specialists progress through four levels (I–IV) with increasing independence, cross-functional expertise, and mentorship responsibilities.

In addition to core credentialing work, this role must be able to handle data entry across multiple units and be cross-trained in various processes to serve as a flexible resource based on evolving business needs. This role provides the opportunity to build a broad range of skills while contributing to different areas of the organization.

For candidates hired into Global Shared Services Philippines, onsite work in Quezon City with a shifting schedule is required.

Duties and Responsibilities

• Support the team by demonstrating proficiency in data management and assisting with foundational knowledge and skills across processes that connect to related departments.
• Contribute to the evolving needs of the business by exhibiting flexibility and adaptability in performing a variety of tasks across multiple workflows.
• Review and analyze documentation provided by vendors, regulators, and professional boards.
• Research, verify, and input credentialing/licensure information according to client requirements.
• Learn and apply compliance standards and regulatory rules to ensure data accuracy.
• Monitor and track case progress, escalating complex issues when appropriate.
• Document findings and maintain detailed case notes for leadership review.
• Support quality assurance through structured training and performance standards.
• Mentor and support peers at higher levels, providing task coordination and workflow guidance (Level III/IV).

Qualifications

• High school diploma or equivalent required; associate or bachelor’s degree preferred, for specific levels.
• Strong attention to detail and ability to follow structured processes.
• Demonstrated ability to navigate the internet for research activities.
• Experience in background screening, credentialing, or compliance research preferred.
• Proficiency with Microsoft Office Suite and case management systems.
• Strong written and verbal communication skills.
• Ability to multitask, meet deadlines, and work in a fast-paced environment.
• Progression through Levels II–IV requires demonstrated proficiency, initiative, and peer support contributions.

Requirements

• Credentialing Specialist I
• Entry-level role focused on learning the foundational workflows of LicenseManager Pro and SanctionCheck.
• Works under close supervision while building familiarity with platforms, policies, and client expectations.
• Key Responsibilities:
• Complete assigned credentialing tasks with direct oversight from senior peers or Supervisor.
• Learn and follow structured workflows and quality review processes.
• Participate actively in training sessions, applying feedback to improve accuracy and speed.
• Escalate complex or unclear cases for review rather than attempting independent resolution.
• Demonstrate consistent attendance, reliability, and willingness to learn.
• Skills:
• Basic research skills and attention to detail.
• Ability to follow structured processes.
• Emerging computer and data-entry proficiency.
• Receptive to coaching and training.
• Credentialing Specialist II
• Builds upon foundational skills to manage a wider variety of cases independently.
• Expected to consistently meet productivity and accuracy benchmarks across multiple products.
• Key Responsibilities:
• Handle credentialing and sanction checks with minimal supervision.
• Apply policies and procedures confidently across different case types.
• Maintain accuracy while multitasking and meeting client deadlines.
• Identify and escalate recurring issues or workflow gaps.
• Support newer Specialists by informally sharing tips and best practices.
• Skills:
• Strong multitasking and organizational skills.
• Intermediate platform and workflow knowledge.
• Reliable time management and ability to meet service-level agreements.
• Clear written communication skills for case documentation.
• Credentialing Specialist III
• Recognized as an experienced resource with cross-functional expertise across LicenseManager Pro and SanctionCheck.
• Trusted to resolve complex cases independently and contribute to process improvements.
• Key Responsibilities:
• Investigate and resolve complex or unusual cases without supervisory intervention.
• Mentor Specialists I and II, supporting their training and development.
• Partner with Supervisors and Quality team to identify process gaps and recommend improvements.
• Provide feedback on workflow efficiency and case-handling best practices.
• Serve as a peer leader, modeling consistency in performance and professionalism.
• Skills:
• Advanced workflow knowledge and investigative skills.
• Problem-solving and decision-making abilities.
• Strong interpersonal and mentoring skills.
• Ability to adapt to new processes, tools, and client needs quickly.
• Credentialing Specialist IV
• Subject matter expert and peer mentor who supports leadership in driving performance standards across the team.
• Balances independent case work with responsibility for peer mentorship, task coordination, and trend tracking.
• Key Responsibilities:
• Mentor and coach peers across all levels to improve performance and quality.
• Coordinate daily task assignments, ensuring balanced workload distribution.
• Track performance trends and provide informal peer-to-peer accountability.
• Partner with Supervisors on quality assurance, performance tracking, and process documentation.
• Act as escalation point for peers when complex cases arise, providing guidance before issues are elevated to leadership.
• Contribute to a positive, high-performance culture by modeling ownership and accountability.
• Skills:
• Expert workflow knowledge across LicenseManager Pro and SanctionCheck.
• Peer mentorship, coaching, and team coordination.
• Strong data awareness with ability to identify performance trends.
• High emotional intelligence, able to influence without formal authority.
• Advanced problem-solving and independent judgment.

Working Conditions

This job operates in a professional office environment or remotely. This role routinely uses general office equipment.

Physical Requirements

• Ability to communicate clearly and exchange accurate information constantly.
• Constantly operates computer, keyboard, copy machine, phone, and other general office equipment.
• Ability to occasionally move objects up to 10 lbs.

Direct Reports

None.