Credentialing Specialist – Credentials Verification Organization

This is a fully remote position, open to applicants in United States.

📋 Description

• Facilitate the application process for CVO providers, including data collection, application processing, and primary source verification.

• Assist with the onboarding and offboarding of providers.

• Manage credentialing and re-credentialing applications for new applicants.

• Ensure that all applications are complete, accurate, and compliant; address discrepancies as needed.

• Prepare documentation and files for the review of the Medical Director, Credential Committee, and Medical Staff Office.

• Collaborate with credentialing auditors to rectify any deficiencies.

• Organize and maintain provider data and files efficiently.

• Process applications in accordance with turnaround times, accuracy, and regulatory standards.

• Keep provider information up-to-date in the provider database.

• Complete credentialing compliance checkpoints prior to file release.

• Stay informed about TJC, NCQA, CMS, and other regulatory guidelines through ongoing education.

• Engage with colleagues, customer relations, MSO representatives, and leadership to gather missing information and resolve issues.

• Perform additional job-related tasks as assigned by the supervisor, within reasonable accommodations.

⛳️ Requirements

• High School diploma or GED is required.

• At least 1 year of recent experience in medical staff services or a CVO setting is preferred.

• CPMSM or CPCS certification from NAMSS is preferred.

• Familiarity with Credentialstream credentialing software is preferred.

• Must adhere to applicable regulatory standards and primary source verification requirements.

• Strong professional communication abilities are essential.

• Commitment to privacy and confidentiality is required.

🏝️ Benefits

• Competitive salary.

• Incentive programs.

• Referral bonuses.

• 403(b) retirement plan with employer contributions (when eligible).

• Comprehensive medical, dental, vision, and prescription coverage.

• HSA/FSA options available.

• Life insurance coverage.

• Resources and discounts for mental health support.

• Paid time off.

• Parental leave and FMLA leave.

• Short- and long-term disability benefits.

• Backup care services for children and elders.

• Tuition assistance programs.

• Support for professional development and continuing education.