Credentialing Specialist

POSITION SUMMARY A credentialing specialist is responsible for verifying and maintaining the qualifications and credentials of healthcare professionals to ensure compliance with industry standards, regulatory requirements, and client policies. This role is crucial in ensuring that medical providers are properly licensed, certified, and trained to deliver safe and effective care. ESSENTIAL FUNCTIONS: The credentialing specialist is responsible for collecting, verifying, and processing the credentials of providers. This includes reviewing applications, ensuring compliance with legal and regulatory requirements, and ensuring accurate and timely data into credentialing systems. Responsible for credentialing initial and reappointment applications based on client guidelines Verify the educational background, licensure, board certifications, work history, and references of providers. Ensure that all credentials meet the standards set by client policies, regulations, and the industry. Ensure compliance with federal, state, and organizational regulations, including those from The Joint Commission, AAAHC, and/or NCQA. Performs miscellaneous job-related duties as assigned. POSITION QUALIFICATIONS Education: High school diploma or equivalent required Associate's or Bachelor's degree preferred Experience: A minimum of 3 years' experience directly related to medical provider credentialing in a hospital, managed care, or medical practice environment A minimum of 1 year experience with credentialing software Other Skills: A minimum 1 year of remote work experience Strong attention to detail and ability to handle sensitive information confidentially Excellent organizational and time management skills Ability to manage multiple tasks in a fast-paced environment Strong communications skills (both orally and in writing) to interact with providers, clients, and colleagues. Knowledge of medical terminology and healthcare accreditation standards #J-18808-Ljbffr 3WON, LLC