Provider Credentialing Specialist
Tishman Speyer Properties
Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance, and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end‑to‑end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts’ comprehensive portfolio, including the CareLogic®, Credible™, and InSync® platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non‑profit Certified Community Behavioral Health Clinics (CCBHC) as well as for‑profit large enterprise and small business providers. Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients. Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions. Location: Nashville or Tampa – hybrid schedule in either office. Remote candidates will not be considered. Responsibilities Keep abreast of regulatory developments in the Behavioral Health, Primary Care, and Medical Staff Services industries Maintain compliance with regulatory and accrediting bodies Work collaboratively with leadership in the development and implementation of credentialing processes and procedures Credential physicians, allied health, and other practitioners Conduct insurance paneling of facilities, physicians, allied health, and other practitioners Collect and maintain an accurate practitioner database and analyze verification information Collect and maintain records in licenses, credentials, and insurance contracts Monitor Partner/Customer’s providers’ credentials and licenses Work collaboratively with Partners/Customers to advise on renewal procedures Ensure timely completion of credentialing processes Release information to agencies and members of the public as required by law Escalate identified credentialing risks to the Billing Manager and Partner/Customer leadership Demonstrate subject matter expertise in provider credentialing and processes Develop and maintain credentialing processes and standards for the department Stay informed of credentialing requirements for Joint Commission and CARF Keep abreast of insurance paneling requirements for Medicare, Medicaid, and commercial payers Assist with the development and operations of a customer call center Provide credentialing consultations and training as requested Qualifications Proven experience in provider credentialing and insurance paneling In‑depth knowledge of industry standards and regulations Provider Credentialing Specialist certification through NAMSS (preferred) Ability to delve into the credentialing requirements of Partners Excellent communication and organizational skills Motivation and ability to manage concurrent projects, constituents, and priorities with tight deadlines in a dynamic environment Build positive and effective relationships with other leaders, internally and externally Regarded as a team player by colleagues and demonstrates company values and culture Ensure that all work adheres to company mission and goals Represent the company, mission, and values well to both internal and external stakeholders Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. #J-18808-Ljbffr
- ...USA Travel Requirement: YES, nationwide to support onsite credentialing operations as mission needs require. Security Clearance... ...UPON AWARDING OF GOVERNMENT CONTRACT******** Credentialing Specialists will provide credentialing service and support to operate IRS...SuggestedContract workTemporary workFor contractorsLocal areaRelocationShift workNight shiftWeekend work
- ...Job Description Job Description We are seeking a Credentialing Specialist to join our growing administrative team. This individual will play a vital role in supporting provider onboarding and compliance, ensuring that all practitioners are properly credentialed and...SuggestedContract work
- A national credentialing service provider is seeking Credentialing Specialists in Tampa, Florida. The role involves managing credentialing appointments, issuing identification cards, and ensuring compliance with federal standards. Ideal candidates will possess strong customer...SuggestedContract workRelocation package
$18.86 per hour
...Full-time Description Company Description Citizant is a leading provider of professional IT services to the U.S. government. We seek to... ...Resets. Answering phone calls/email inquiries related to PIV credentials and access control matters. Coordinate and conduct the...SuggestedFull timeFor contractorsLocal areaFlexible hours- ...virtual environment and apply policy and criteria required for credentialing processing. Perform all required primary source verifications... ...1 - 3 years of previous experience as a Credentialing Specialist Knowledge of credentialing regulatory and accreditation requirements...Suggested
$22.62 per hour
The University of South Florida is seeking a Fiscal & Business Specialist - OT Credentialing & Access Services in Tampa. This role provides crucial support for credentialing, billing processes, and customer service. The position requires daily coverages and increased responsibilities...Hourly pay$22.62 per hour
The University of South Florida (usf.edu) is looking for a Fiscal & Business Specialist - OT Credentialing & Access Services in Tampa, FL. This role involves providing crucial support for credentialing services, inventory management, and customer service. The ideal candidate...Hourly payMonday to Friday- The State of Florida is seeking a PROVIDER ENROLLMENT COORDINATOR in Tampa, FL. This position entails responsibility for recruiting, enrolling, and maintaining applicants for Medicaid Waiver services, ensuring that all records are managed accurately in accordance with...Work at office
- ...A leading healthcare staffing firm in Tampa is seeking an experienced Credentialing Specialist to review applications, perform verifications, and liaise with healthcare institutions. This role requires 1-3 years of experience and knowledge of regulatory requirements....
- ...Provider Outreach Specialist The Provider Outreach Specialist is a highly visible, field based role responsible for driving client growth through consistent, in person relationship building with physicians, referral sources, and community partners. This role is predominantly...Work at officeLocal area
$23 per hour
...submit enrollment and re-enrollment applications for healthcare providers to Medicare, Medicaid, and commercial insurance plans. *... ...ensure timely processing. * Collaborate with providers and credentialing staff teams to gather required documentation and resolve discrepancies...Contract workTemporary workRemote work- ...Job Description Job Description Join RadX Inc. as a Full Time Credentialing Specialist and immerse yourself in the dynamic world of health care right here in sunny Tampa, FL! This onsite position offers you the chance to be part of a high-performance team dedicated...Full timePart timeWork at office
- Elevance Health is hiring a Legal Specialist Senior in Tampa, Florida. This role involves providing comprehensive legal support in contract negotiations across various healthcare services. Successful candidates will engage in drafting, revising contracts, and ensuring compliance...Contract work
- A child welfare organization in Tampa is seeking a Training Specialist to develop and implement comprehensive training programs for child welfare professionals. This position requires strong communication and organizational skills, an understanding of child welfare standards...
- Who You Are The Global Virus Network (GVN) is seeking a freelance Medical/Grant Writer to provide medical writing, scientific communications, and grant development support. This consultant will support the preparation of high‑quality scientific, programmatic, and funding...Freelance
- ...Join Our Growing Team as a full-time Compliance Specialist with Richman Property Services, Inc. (RPS), in Tampa, FL! Are you a bold, visionary... .... Richman Property Services is an equal opportunity employer, providing employment opportunities to all qualified applicants...Full timeWork at officeLocal areaRemote work2 days per week3 days per week
- ...Compliance Specialist Contractor The Compliance Specialist Contractor is an entry-level role within the Compliance Department designed... ...quality assurance activities with organizational objectives. Provide support for team training and development by sharing insights...For contractors
- ...development, advancement and having fun! Summary The Trade Compliance Specialist will be responsible for complying the company's Trade... ...submitting DDTC and BIS Export Licensing requirements. Must be able to provide approvals on the determination and usage of BIS Exceptions and...Contract workWork experience placementLocal areaWorldwideFlexible hoursShift work
$27.67k - $58.87k
Lawn Specialist 330 E Douglas Rd, Oldsmar, Florida 34677 TruGreen accepts applications on an ongoing basis. Job Description... ...solutions during customer visits and calls Measure properties and provide quotes for TruGreen services Maintain accurate records of...Hourly payFull timeLocal area- ...Provider Network Administration Provider Network Administration is responsible for the accurate and timely validation, analysis... ...and governance of critical provider information across claims, credentialing, contracting, and provider network systems. This role serves...Work at office
- ...corrective action plans, and communicate and escalate identified risks as necessary. Facilitate compliance risk mitigation efforts by providing monitoring and oversight of remediation efforts to support ongoing compliance. Perform other duties as assigned. Qualifications 5+...Temporary workWork at office
- ...Help - Incumbent serves as an expert intelligence operational specialist who performs analyses of Combatant Command requirements for... ...professionals at other intelligence agencies and allied countries to provide or obtain information on complex and unique problems and...Full timeContract workTemporary workPart timeWork experience placementWork at officeWorldwideTrial periodRelocation packageShift workAfternoon shift
- ...Title Incumbent serves as an expert intelligence operational specialist who performs analyses of Combatant Command requirements for... ...professionals at other intelligence agencies and allied countries to provide or obtain information on complex and unique problems and...
- ...Elevate Lives as an Occupational Therapy Specialist in the Vibrant Tampa Bay Area Overview Are you a dedicated Occupational... ...recent graduate excited to embark on your career, this position provides the ideal opportunity to engage in work that truly matters...Full timeLocal areaShift work
- ...Counterintelligence Specialist Founded in 1989, SOSi is among the largest private, founder-owned technology and services integrators... ...support of HUMINT asset validation and HUMINT source management. Provide recommendations to the U.S. Government regarding CI/HUMINT...Contract workWork at officeWorldwide
- ...communities are vibrant. LSF is seeking a talented Family Specialist who wants to make an impact in the lives of others. Purpose and Impact: The Family Specialist is responsible for providing Center orientation to new families and providing direct...Part timeWork at officeFlexible hoursAfternoon shift
- ...performance! This position requires an active TS/SCI CI Poly clearance. Responsibilities: The Intelligence Management Specialist (Operations) – Sr. provides comprehensive intelligence and administrative support to analysts, engineers, and scientists across multiple...
- ...Job Description Surgical Sterile Processing Specialist 2 - Sterile Processing (260001RW) Job Summary Under general supervision of Sterile... .... This includes working in conjunction with the customer to provide timely sterile products, trays, and case carts where applicable...Full timeMonday to Friday
- ...Construction Specialist Ready to build a strong future in construction? We're looking for a Construction Specialist to keep our Mechanical... ...with electricians, plumbers, and mechanical teams to provide general labor support across trades Follow safety standards...Temporary workApprenticeshipFlexible hours
$17 - $19 per hour
...development and community engagement, is seeking a Tampa Youth Program Specialist to join their team. As a Tampa Youth Program Specialist, you... ...and their guardians to ensure awareness and engagement. Provide guidance and instruction to youth on required activities and...Full timeTemporary workSummer workShift workDay shift
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