Customer Due Diligence Analyst

About the Team

Our Credentialing team plays a critical role in ensuring legal, regulatory, and procedural compliance across all submitted applications. We partner closely with internal business units and external customers to deliver timely, accurate decisions while maintaining the highest standards of documentation, communication, and customer service. The team operates in a dynamic environment where policies are updated frequently, requiring strong attention to detail, investigative skills, and a commitment to applying approved interpretations outlined in the Credentialing Manual.

About the Role

In this role, you will be responsible for reviewing and assessing credentialing applications to ensure compliance with legal, regulatory, and internal policy requirements. You will utilize established guidelines, tools, and the Credentialing Manual to make informed pass/fail decisions while providing clear, professional communication to applicants and internal stakeholders. The role involves daily interaction with customers, meticulous documentation, and ongoing training to stay current with policy updates. Success in this position requires excellent communication skills, strong customer focus, and the ability to navigate a production-based environment with accuracy and urgency.

Responsibilities

• Manage a working queue to meet productivity, accuracy, and SLA targets.

• Perform credentialing reviews based on the specific request type and apply complex, documented policies and procedures accurately.

• Respond to inquiries from internal departments and external customers regarding application status.

• Communicate with applicants and customers via phone and email to gather required documentation and provide final credentialing decisions.

• Use multiple systems, tools, and verification products to confirm credentialing standards are met.

• Make accurate final “pass” or “fail” decisions based on regulatory and policy requirements.

• Document all findings, actions, and communications in the credentialing system (MBS‑ECT) for FTC, vendor/provider, audit, and data retention purposes.

• Maintain high-quality communication using clear, concise, and customer‑appropriate language.

• Attend quarterly policy and procedure training sessions, as well as annual refresher training, applying frequent updates (40–45 per year) to daily work.

• Ensure all credentialing decisions adhere to legal and regulatory requirements and reflect the approved interpretations outlined in the Credentialing Manual.

Requirements

• High School Diploma, Bachelor’s degree (preferred but not required), or current college with experience supporting back‑office and customer-facing tasks.

• 1–2 years of general business experience preferred.

• Experience in a customer-facing role with a strong commitment to delivering excellent customer service.

• Strong verbal and written communication skills with the ability to explain complex information clearly.

• Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).

• Strong sense of urgency with the ability to maintain accuracy and attention to detail.

• Ability to prioritize tasks and adapt quickly in a production-driven environment.

• Investigative mindset with excellent attention to detail.

• Strong organizational skills and the ability to make sound decisions.

• Willingness to work during business-aligned hours (EST).