Credentialing Specialist

Job Summary

A company is looking for a Credential Specialist to ensure healthcare providers meet professional standards and regulatory criteria.

Key Responsibilities

• Lead the processing of initial applications and re-appointments for providers, ensuring accuracy and timeliness
• Conduct thorough verification of provider credentials in accordance with NCQA, URAC, and The Joint Commission standards
• Maintain the credentialing database to ensure real-time accuracy of provider profiles and track expiration dates

Required Qualifications

• Minimum of 2-3 years in healthcare credentialing, medical staff services, or provider enrollment
• Deep proficiency in NCQA, CMS, and The Joint Commission guidelines
• Advanced skills in Microsoft Office Suite and experience with credentialing software
• High school diploma or GED required; Associate or Bachelor's degree in Healthcare Administration preferred
• Exceptional organizational skills with a high degree of accuracy in data entry and document review