Credentialing Administrator

Job Summary

To support the Medical Staff Services Department, the full-time remote Credentialing Administrator will coordinate practitioner credentialing, privileging, and primary source verifications while ensuring compliance with accreditation standards and regulatory requirements.

Key responsibilities

• Coordinates departmental activities to maintain quality in credentialing and privileging processes
• Assists with the NCQA Accreditation application and survey process, ensuring compliance with regulatory agencies
• Develops and implements tools for data management and process improvement within the credentialing framework

Required qualifications

• Associate's degree in business or healthcare-related field and 3 years of experience in medical staff credentialing or payer enrollment functions
• Knowledge of Joint Commission, CMS, and NCQA regulations related to medical staff services preferred
• Proficiency in MS Office applications (Word, Excel, PowerPoint) required
• Certified Medical Professional Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred upon hire
• Experience with criteria-based clinical privileging processes preferred