Credentialing Specialist
6 days ago
Job Description Processes credentialing and re-credentialing applications for the client. Reviews applications and prepares verification letters. Contacts various departments, licensing agencies, and insurance carriers to complete credentialing and re-credentialing applications. Provides support to the client in the collection and query of credentials of members of the client. Conducts Primary Source Verification (PSV) of credentials such as licenses, certifications, registrations, professional school education, postgraduate, residency, or specialty training, board certifications, work history, and current references. Conducts queries through the National Practitioner Data Bank (NPDB), the Defense Practitioner Data Bank (DPDB), the Department of Health and Human Services (DHHS) and TRICARE sanction data banks. Collects professional/peer references and completed clinical privileges, demographics, military and civilian practice history (including adverse privileging actions and malpractice history), health status, documentation of contingency and continuing education training, national provider identification number, and for non-personal services contract providers malpractice insurance information. Accurately loads appropriate data in the DoD Centralized Credentials Quality Assurance System (CCQAS). Keeps records and documentation of the applications and verifications maintained. Establishes and maintains updated CCQAS records. Researches and solves credentialing/re-credentialing problems; escalates more complex issues as appropriate. Tracks status of credentials for healthcare practitioners and provides required documents to clients to make accession, credentialing and privileging (C&P) decisions. Maintains relationships with Military Treatment Facilities and supported customers. Ensures providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities. Reviews records for regulatory compliance and quality assurance at a healthcare facility, insurance group, or similar organization, ensuring relevant regulations are met. Minimum Qualifications US Citizen with HS diploma or GED; Bachelor's Degree in healthcare or business field preferred Certified Provider Credentialing Specialist (CPCS) preferred 2-5 years of experience performing physician credentialing at a medical group, hospital or health plan. Must be able to Pass a government background check Other Job Specific Skills Strong customer focus, interpersonal, collaboration, written/verbal communication, prioritization and computer skills. Strong attention to detail and good organizational capability. Able to handle multiple simultaneous tasks and complete work projects in designed time frames. Knowledge of Department of Defense credentialing guidelines preferred. Experience using Centralized Credentials Quality Assurance System (CCQAS) and Defense Medical Human Resources System - internet (DMHRSi) a plus. Ability to handle confidential information on a daily basis in a professional manner. Ability to consistently maintain quality and production expectations. Possess proof-reading skills sufficient for auditing documents. Demonstrate familiarity with credentialing policies, guidelines, and regulations for the DoD credentialing process.
-
Credentialing Specialist
6 days ago
Forest Park, GA, United States ASM Research Full timeProcesses credentialing and re-credentialing applications for the client. Reviews applications and prepares verification letters. Contacts various departments, licensing agencies, and insurance carriers to complete credentialing and re-credentialing applications. Provides support to the client in the collection and query of credentials of members of the...
-
Credentialing Specialists
2 weeks ago
Lake Forest, United States Armada Ltd Full timeType: Full TimeLocation: Lake Forest, CAOvertime Exempt: YesReports To: ARMADA HQTravel Requirement: YES, nationwide to support onsite credentialing operations as mission needs require.Security Clearance Required: N/A*************CONTINGENT UPON AWARDING OF GOVERNMENT CONTRACT********Credentialing Specialists will provide credentialing service and support to...
-
Credentialing Specialists
3 days ago
Lake Forest, CA, United States Armada Full timeType: Full Time Location: Lake Forest, CA Overtime Exempt: Yes Reports To: ARMADA HQ Travel Requirement: YES, nationwide to support onsite credentialing operations as mission needs require. Security Clearance Required: N/A *************CONTINGENT UPON AWARDING OF GOVERNMENT CONTRACT******** Credentialing Specialists will provide credentialing service and...
-
Credentialing Specialist
2 weeks ago
Lake Forest Park, Washington, United States ASM Research Full time $60,000 - $90,000 per yearProcesses credentialing and re-credentialing applications for the client. Reviews applications and prepares verification letters. Contacts various departments, licensing agencies, and insurance carriers to complete credentialing and re-credentialing applications. Provides support to the client in the collection and query of credentials of members of the...
-
Identity and Driver Credential Specialist 1
2 weeks ago
Forest Park, Georgia, United States State of Georgia - Driver Services, Georgia Department of - DDS Full time $35,500 per yearAdditional InformationAgency Logo:Requisition ID: ADM0J2PNumber of Openings: 1Advertised Salary: 35,500.00Shift: Day JobPosting End Date: Dec 12, 2025Are you looking for a fast-paced job that will allow you to utilize your superior customer service skills in a rewarding environment?Are you dependable and motivated with a strong commitment to providing...
-
Identity and Driver Credential Specialist 1
2 days ago
Forest Park, Georgia, United States State of Georgia Full timeAre you looking for a fast-paced job that will allow you to utilize your superior customer service skills in a rewarding environment?Are you dependable and motivated with a strong commitment to providing excellent customer service?Are you looking for a career path in public service?If you answered "yes" to all these questions, then the Department of Driver...
-
Credentialing Specialist
1 week ago
Overland Park, United States Connect Staffing and Consulting Full timeCredentialing Specialist Location: Fully Remote (based in Overland Park, KS) About My Client My client is a rapidly growing healthcare services organization that delivers onsite dental, vision, hearing, and podiatry care to long-term care and skilled nursing facilities across multiple states. With a reputation for innovation, operational excellence, and...
-
Onboarding and Credentialing Specialist
3 weeks ago
Brooklyn Park, United States Mains'l Services Full timeMains'l is seeking an Onboarding and Credentialing Specialist. This role will play a crucial role in supporting the setup and ongoing credentialing of vendors and employees in the Self Determination Program. The Onboarding and Credentialing Specialist will partner with other FMS team members to ensure that all necessary documentation is completed and...
-
Onboarding and Credentialing Specialist
2 weeks ago
Brooklyn Park, MN, United States Mains'l Services Full timeMains'l is seeking an Onboarding and Credentialing Specialist. This role will play a crucial role in supporting the setup and ongoing credentialing of vendors and employees in the Self Determination Program. The Onboarding and Credentialing Specialist will partner with other FMS team members to ensure that all necessary documentation is completed and...
-
Onboarding and Credentialing Specialist
5 days ago
Brooklyn Park, MN, United States Mains'l Services Full timeMains'l is seeking an Onboarding and Credentialing Specialist. This role will play a crucial role in supporting the setup and ongoing credentialing of vendors and employees in the Self Determination Program. The Onboarding and Credentialing Specialist will partner with other FMS team members to ensure that all necessary documentation is completed and...
