Delegated Credentialing Specialist - Payer Compliance & Audits
Tava Health
Tava Health is seeking a Delegated Credentialing Specialist to own the day-to-day credentialing operations across payer relationships. You will manage audits, compliance reporting, and data reconciliation, while partnering with internal teams and delegated entities. This role supports credentialing for Nurse Practitioners and group practices. Ideal candidates have 2–5 years in credentialing (2+ in delegated credentialing) and CPCS certification, with strong attention to detail and #J-18808-Ljbffr Tava Health
- ...we’d love to meet you. ABOUT THE ROLE The Delegated Credentialing Specialist owns the day-to-day execution of Tava... ...delegated credentialing program across assigned payer relationships. This role manages payer audits, compliance reporting, audit-ready credentialing files...SuggestedWeekly payH1bVisa sponsorshipWork visa
- Overview Join to apply for the Delegated Credentialing Specialist role at The Ohio State University Wexner Medical Center . Current employees and... ...source verification and medical staff privileging, assuring compliance with NCQA and JCAHO standards. Also, responsibility will...SuggestedFull timeTemporary workWork at office
- Integrated Services for Behavioral Health (ISBH) is seeking a Credentialing Specialist to manage provider credentialing and related billing... ...role emphasizes Medicaid, with potential Medicare or private payer work, and involves maintaining portals like CAQH, PECOS, and...Suggested
$23.85 - $28.02 per hour
...Job Description Job Description We are seeking a Credentialing Specialist! Southeast, OH Integrated Services for Behavioral Health (ISBH... ...on Medicaid, though may work with Medicare and/or private payers. The pay range for this position is $23.85 - $28.02 per...SuggestedHourly payTemporary workWork at officeLocal area- A prominent healthcare institution in Ohio is seeking a Delegated Credentialing Specialist to oversee the credentialing of providers. This role requires a Bachelor's degree and four years of experience in a hospital or managed care setting. Strong communication and organizational...Suggested
- Credentialing SpecialistAndHealth is on a mission to radically... ...Credentialing Specialist who can play a key role in the payer enrollment and credentialing... ...external partners to ensure compliance and uphold the highest... ...use and external audits.Establish and maintain...Full timeTemporary workWork at office
$20 - $23.5 per hour
...driven by integrity and a culture of compliance, CBC Companies delivers high quality... ...our customers manage risk. TITLE: Credentialing Specialist REPORTS TO: Credentialing Manager... ...procedures Support departmental audits, compliance reviews, and process...Hourly payTemporary workWork at officeLocal areaRemote workMonday to FridayNight shift- ...Orthopedic One is seeking a Credentialing Coordinator to manage provider credentialing across hospitals and boards, ensuring timely licensure updates and accurate PECOS maintenance. You will coordinate with credentialing vendors and providers to keep records current and...
- ...direction, perform analysis to accomplish work plans initiated by various governmental agencies for rate cases, recovery clauses, audits, compliance filings, policy matters, and/or other proceedings. With support, guidance, and direction, completes requested tasks to gather...Full timeWork experience placementWeekend work
- ...problems or perform analysis to accomplish work plans initiated by various governmental agencies for rate cases, recovery clauses, audits, compliance filings, policy matters, and/or other proceedings. Provides expert level input for corporate and business unit regulatory...Full timeWeekend work
- Signature Performance, Inc. is seeking a Compliance Program Analyst to join our remote team nationwide. You will help develop, implement,... ...supporting governance, policy management, third-party oversight, and audit readiness. Ideal candidates have 5+ years in compliance,...Remote job
- ...transfer to your application. Job Title:Compliance Senior Analyst, Auditor Department:... ...limited to investigations, monitoring and auditing, staff education, and regulatory... ...Position Description: The Compliance Specialist position is an auditor position, and its...Temporary workWork experience placementWork at officeLocal areaShift workDay shift
- Our Town Studios is seeking a Billing & Compliance Coordinator in Columbus, Ohio. This role is essential for ensuring Medicaid waiver billing... ...vibrant environment. You will monitor billing trends, conduct audits, and work collaboratively with leadership. The ideal candidate...
$50k - $55k
Billing & Compliance Coordinator Join Our Team at Our Town Studios. At Our Town Studios, we believe in the power of creativity and compassion... ...compliance with DODD and agency requirements, conducting audits, and working collaboratively with Program Coordinators and leadership...Work at office- ...Vice President, Banking Compliance, HMDA & CRA Officer About the Company A bank strengthening its compliance program across lending... ...5 years' of experience in bank compliance, risk management, or audit, with a focus on HMDA, CRA, and Fair Lending programs. A strong...
- ...Overview: The Senior Clinical Research Training and Compliance Coordinator plays an integral role in the training and compliance processes... ...of clinical research topics as well as quality assurance audits to enhance compliance with regulations. Job Description...Full timeLocal areaFlexible hours
- First Merchants Bank is seeking an HR Risk & Compliance Specialist to join our team. This role provides operational and administrative support... ...risk management, compliance, governance, investigations, and audit activities. You will assist with risk assessments, audits,...
- CVS Health is seeking a Senior Coordinator, Business Compliance to support and monitor operations for regulatory adherence. You will conduct audits, investigate issues, and drive improvements across SOPs, reporting, and training. The role interfaces with operations, leadership...
- ...Position Summary The Regulatory Compliance Specialist is responsible for reviewing Incoming ingredients, components and preprinted packaging... ...Supervisor. The Regulatory Compliance Supervisor may delegate responsibilities. Duties and Responsibilities Major...InternshipWork at office
- ...Union Inc. is seeking an Operations Quality Controls Specialist to support branch operations, audits, and controls across multiple locations. You will... ...leadership. The role emphasizes documentation, regulatory compliance, and continuous improvement, with travel between...
- Woda Cooper Companies, Inc. is seeking a Portfolio Manager/Compliance Analyst to work remotely with limited travel. You will manage audits, occupancy reporting, and investor-ready documentation for a diverse affordable housing portfolio across multiple states. The role...Remote jobWork at office
- The Village Network in Columbus, OH is seeking a Licensing Specialist to support the licensing processes for foster parents, aligning with... .... You will handle recertifications, home studies, and state audits, and help ensure files and documentation are in order. Candidates...
- ...oversight of the Anti-Money Laundering framework within Second Line Compliance. You will apply sound regulatory judgement across key AML... ...review and approval of Suspicious Activity Reports under MLRO delegation, while partnering closely with AML Operations, MLROs, and...Local areaShift work
$85k
...provide exceptional legal and compliance services to our internal... ...FWA issues and investigate and audit provider billing and UM auth... ...with our Compliance Manager, Payer Division and partner with individuals... ...Collaborate with our credentialing, quality assurance, and network...Full timeTemporary workLocal areaRemote work- ...timekeeping and payroll systems, and updating employee records with pay rate changes and status updates. The role requires strong communication, audit skills, and the ability to handle inquiries from employees, vendors, and external agencies. #J-18808-Ljbffr Nationwide-Children
$90k - $110k
...position. Applicants can be located nationwide Compliance Program Analyst #2891 United States... ...party compliance monitoring, and enterprise audit readiness. Tell us about your experience... ...Requirements Experience in healthcare payer, federal healthcare, managed care, government...Remote jobFull timeContract workTemporary workFor subcontractorWork at officeMonday to Friday- ...partners we serve. We are looking for a Senior Security Risk & Compliance Analyst to support and strengthen APCO’s security governance,... ...security posture and regulatory compliance. What You'll Do Audit & Compliance Support the planning, coordination, and...Temporary work
- CareRite Centers, LLC in Ohio is seeking a Full-Time Nurse to support our Clinical Auditing and Compliance satellite office. The role focuses on writing appeals, following up on audits and denials, and managing claims with attention to accuracy and timeliness. You will...Full timeWork at office
- ...Job Description Job Description We’re looking for a Food Safety & Compliance Specialist to join our team in Columbus, OH and report to the Director of Production, Quality Assurance & Food Safety. This role plays an important part in ensuring our products, processes...Work at officeWork from homeMonday to Friday
- Kroger in Westerville, OH seeks an auditor to oversee all store audits and inventories, including third-party inventories and internal audits, ensuring policy compliance and accurate recording of results. You will communicate findings to the division office and RASC and...Work at office
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