Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist - Professional.

Key Responsibilities

• Manage the credentialing and recredentialing process for practitioner applicants
• Conduct primary source verifications and ensure compliance with regulatory criteria
• Maintain confidentiality and accuracy of practitioner information in the credentialing database

Required Qualifications

• High school diploma required; Associate degree preferred
• 1-4 years of experience in hospital or insurance plan credentialing
• Knowledge of Joint Commission, NCQA, URAC, HFAP standards
• Certification as a Provider Credentialing Specialist (CPCS) preferred