Credentialing Specialist

3 days ago


Phoenix, Arizona, United States LHH Full time

Job Title: Credentialing Coordinator

Location: Remote

Pay Range: $24-29/hour (Based on Experience)

LHH is seeking a skilled Credentialing Coordinator to join our team. This role involves gathering and verifying critical primary source documentation, ensuring compliance, and maintaining accurate credentialing records for healthcare professionals.

Responsibilities:

  • Gather and verify primary source documentation for licenses, board certifications, professional references, malpractice policies, hospital affiliations, and previous work history.
  • Initiate and complete CAQH accounts online.
  • Maintain credentialing database by updating information received during initial credentialing and re-credentialing processes.
  • Assist in compliance with accrediting and regulatory agencies (i.e., JCAHO, NCQA) regarding credentialing, while developing and maintaining a working knowledge of statutes and laws.
  • Assist in preparing for audits by health plans for delegated status.
  • Internally audit, organize, and maintain provider files and information in accordance with established legal documentation principles, following confidentiality guidelines.
  • Employ public relations skills in a wide variety of contacts with internal and external sources to solicit essential information for credential investigations.

Qualifications:

Education details - High school diploma or equivalent required. - Certification by the National Association of Medical Staff Services in Certified Professional Medical Services Management (CPMSM) or Certified Professional Credentialing Specialist (CPCS) preferred. - 3+ years of credentialing experience in a hospital or managed care setting preferred. Required Skills: - Experience in credentialing - Knowledge of primary source verification Preferred Skills: - Certification in CPMSM or CPCS

Pay range and compensation package: Pay range or salary or compensation Equal Opportunity Statement: LHH is an equal opportunity employer and welcomes applications from diverse candidates. If you meet the qualifications and are interested in this role, please apply today.



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