Credentialing Specialist

Job Description

Job Description

Credentialing Specialist at KVC Health Systems

Support Excellence in Care Through Precision and Compliance

KVC Health Systems is seeking a dedicated and detail-oriented Credentialing Specialist to join our team. This vital role manages the comprehensive lifecycle of onboarding, credentialing, re-credentialing, and privileging for all medical and therapy providers. By ensuring 100% compliance with Joint Commission (TJC), CMS, and state Medicaid standards, you will directly support clinical safety and financial revenue integrity.

At KVC, we prioritize the health and happiness of our team. We are proud to share that our organization holds a Work Wellbeing Score of 86 , reflecting our commitment to a supportive, inclusive, and fulfilling professional environment.

Work Location:

-Hybrid; in office 2 days a week 

As a Credentialing Specialist, you will act as a critical gatekeeper for quality care. Your technical deliverables include:

• Rigorous Onboarding: Collecting and documenting all pre-employment compliance items, including background checks and out-of-state registry verifications.
• Primary Source Verification: Executing thorough verification of medical licenses, DEA registrations, board certifications, and education to ensure every practitioner meets our high standards.
• Proactive Lifecycle Management: Utilizing a 60-90 day notification protocol to facilitate the renewal of expiring licenses and insurances, preventing any lapses in care.
• Compliance Auditing: Maintaining survey-ready files and conducting regular audits of credentialing folders to ensure continuous readiness for regulatory reviews.
• Committee Support: Preparing credentialing packets for the Medical Executive Committee and Governing Board while providing risk updates to leadership.

We are seeking a professional who embodies the "KVC Way"—combining a zero-error mindset with trauma-informed professionalism. The ideal candidate possesses:

• Education: A High School diploma is required; a Bachelor’s degree in HR or Healthcare Administration is preferred.
• Experience: At least 2 years of credentialing experience. Knowledge of TJC and NCQA standards is highly preferred.
• Certification: Certified Provider Credentialing Specialist (CPCS) is preferred.
• Licensure: A valid driver’s license and current auto insurance.
• Essential Skills: Strong communication, independent judgment, and the ability to manage highly confidential information with discretion.

• Experience working with children and families in a trauma-informed environment.
• Demonstrated ability to work seamlessly across HR, clinical, and billing departments.
• Self-motivated discipline with the ability to prioritize work in a fast-paced environment.

If you are a solutions-focused professional who takes ownership of complex processes and values integrity in healthcare administration, we invite you to apply. Help us maintain a strong continuum of care and ensure a smooth onboarding experience for the providers who serve our communities.

KVC Health Systems: Where Care and Compliance Meet.