Senior Credentialing Specialist
ThemeSoft
We are seeking an experienced Senior Credentialing Specialist with expertise in CVO (Credentials Verification Organization) operations, Provider Credentialing, and Provider Enrolment. The candidate will be responsible for managing the end-to-end credentialing lifecycle, including Primary Source Verification (PSV), regulatory compliance, provider onboarding, re-credentialing, and payer enrolment activities. Key Requirements: 5 - 8 years of experience in provider credentialing and CVO operations. Strong experience in PSV, CAQH, provider enrolment, and re-credentialing. Knowledge of NCQA, CMS, Joint Commission, OIG, and SAM compliance requirements. Experience verifying provider licenses, education, certifications, work history, malpractice coverage, and sanctions screening Hands-on experience with credentialing platforms Ability to manage credentialing files, support committee reviews, maintain provider data, and ensure SLA adherence Preferred Background: Candidates from healthcare payers, hospitals, health systems, managed care organizations, or credentialing service providers with relevant certifications (CPCS, CPMSM) are highly preferred #J-18808-Ljbffr
Vacancy posted 1 day ago
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