Credentialing Specialist

GeneralGeneralFull TimeRemoteSeniorTeam 11-50Since 2010H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

16 hours ago

Salary

0

Seniority

Senior

High School5 yrs expEnglish

Job Description

Credentialing Specialist

Prairie Band, LLC

• The Credentialing Specialist is responsible for coordinating and managing the credentialing, recredentialing, and privileging processes for healthcare providers supporting federal, state, tribal, and other government healthcare contracts. • This position ensures compliance with contract requirements, regulatory standards, accreditation guidelines, and organizational policies. • The Credentialing Specialist serves as the primary liaison between providers, contracting agencies, licensing boards, and internal departments to ensure providers are fully credentialed and eligible for assignment. • Maintain accurate and complete credentialing files in accordance with contract and regulatory requirements. • Monitor expiration dates and proactively obtain updated documentation before expiration. • Ensure compliance with requirements established by Indian Health Service (IHS), Department of Defense (DoD), Veterans Affairs (VA), and The Joint Commission. • Review contract-specific credentialing requirements and ensure provider files meet all standards prior to deployment. • Assist with provider onboarding and clearance processes required for federal facilities. • Conduct periodic audits of credentialing files to ensure accuracy and compliance. • Generate reports on credentialing status, upcoming expirations, and provider readiness. • Identify opportunities to improve credentialing workflows and turnaround times.

Job Requirements

  • High School diploma or GED required.
  • Degree in business, or related field preferred.
  • Minimum of 5 years of healthcare credentialing experience credentialing government healthcare contractors.
  • Must have experience with the government eApp and MD App.
  • Must have familiarity with government agencies such as Indian Health Service (IHS), VA, or DoD.
  • Proficiency in Microsoft Office Suite (Excel, Word, Outlook, PowerPoint).
  • Strong understanding of credentialing regulations and industry standards.
  • Familiarity with NPDB, PECOS, CAQH, OIG, SAM, and state licensing boards.
  • Excellent organizational and time-management skills.
  • Strong attention to detail and accuracy.
  • Ability to manage multiple credentialing files and deadlines simultaneously.
  • Excellent verbal and written communication skills.
  • Proficiency with Microsoft Office Suite and credentialing management systems.

Benefits

  • Full Time Remote

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