Advanced Credentialing Specialist

Indiana University Health; Roanoke (IN); On-site; USD 65,000 - 85,000; Full time

Job summary

Indiana University Health is seeking an Advanced Credentialing Specialist to coordinate credentialing and privileging activities for medical staff and licensed practitioners. The role focuses on primary source verification, processes, and compliance with accreditation standards and regulations.

The ideal candidate will have a Bachelor's Degree or equivalent experience, 2–4 years in credentialing, and familiarity with credentialing software and Microsoft 365. CPCS certification is preferred.

Qualifications

• Bachelor's Degree or equivalent years of experience required.
• Requires 2-4 years of relevant credentialing experience.
• CPCS certification preferred.
• Proficiency in Microsoft 365 applications (Word, Excel, PowerPoint, Outlook).
• Working knowledge of credentialing software preferred.

Responsibilities

• Coordinate and conduct comprehensive primary source verification for medical staff and licensed practitioners.
• Facilitate credentialing, recredentialing, and privileging processes.
• Support ongoing clinical competency evaluations and peer review activities.
• Ensure compliance with Medical Staff Bylaws, policies, accreditation standards, and regulations.
• Lead or support process improvements and staff training within credentialing operations.

Skills

Primary Source Verification

Credentialing Software

Microsoft 365

Quality & Compliance

Regulatory Knowledge

Education

Bachelor's Degree or equivalent

CPCS certification preferred

Tools

Credentialing Software

Job description

Advanced Credentialing Specialist

Overview

Advanced Credentialing Specialist

Our leaders shape strategic initiatives, develop passionate teams, and work to improve health outcomes.They advance our mission and exemplify excellence, compassion, teamwork and purpose in all that they do. Indiana University Health is seeking individuals who embody these values to join our Medical Staff Services Team in the role of Advanced Credentialing Specialist.

The Advanced Credentialing Specialist supports IU Health's patient safety, quality, and regulatory compliance objectives through the coordination and execution of complex credentialing and privileging activities for medical staff and licensed practitioners. This role is responsible for conducting and maintaining comprehensive primary source verification; facilitating credentialing, recredentialing, and privileging processes; supporting ongoing clinical competency evaluations; managing peer review activities; and facilitating Medical Staff functions in accordance with Medical Staff Bylaws, organizational policies, accreditation standards, and federal and state regulations. The Advanced Credentialing Specialist applies critical thinking and professional judgment to analyze credentialing information, identify discrepancies, evaluate trends and potential risk indicators, and ensure practitioner records are accurate, complete, and maintained within designated systems to support informed, risk-based decision-making. Leveraging advanced knowledge of regulatory and accreditation requirements, this individual helps ensure compliant credentialing practices and quality outcomes across the organization. Additionally, the Advanced Credentialing Specialist serves as a resource and mentor to credentialing staff by supporting training, onboarding, and professional development efforts. This role contributes to the development, interpretation, and maintenance of credentialing policies and procedures, participates in audits and quality reviews, and leads or supports process improvement initiatives to enhance operational effectiveness, consistency, compliance, and continuous improvement throughout credentialing operations.

Minimum Candidate Qualifications

• Bachelor's Degree or equivalent years of experience is required.
• Requires 2-4 years of relevant experience.
• Certified Provider Credentialing Specialist (CPCS) certification is preferred.
• Requires proficiency in Microsoft 365 applications (Word, Excel, PowerPoint, Outlook).
• Working knowledge of credentialing software is preferred.

Responsibilities

• Connect to Promise - Demonstrates a commitment to IU Health's mission, vision, and values by exhibiting behaviors and delivering results that align with the strategic direction of the organization. Ensure IU Health is working toward its vision of improving the health of all Hoosiers by providing the best care for each person as we practice our values of purpose, excellence, compassion and team.
• Business Acumen - Demonstrates understanding of the department and function and how they are structured. Actively seeks knowledge regarding the goals and operations of department and function, and guidance on how to best align work to achieve departmental goals.
• Leadership - Takes the initiative to proactively resolve issues, address concerns, identify potential risks, and improve overall processes and outcomes.
• Critical Thinking - Leverages curiosity and insights to explore rationale behind decision-making. Connects pieces of information from various sources to improve problem solving capabilities and recommendations. Recognizes and distinguishes questions, problems, and conflict.
• Analysis - Analyzes problems and opportunities as they arise. Takes into account all fact-based information available to provide meaningful suggestions. Asks appropriate follow up questions to try to determine the root cause of the problem.
• Independent Judgment Exhibits sound professional judgment and diplomacy in handling unexpected problems and frequent interruptions that require immediate action or attention. Seeks appropriate guidance when determining next steps.
• Adaptability - Adapts to changes in job demands, work priorities, and organizational structure without adverse effects on job performance. Takes guidance and instruction from leaders and implements accordingly.
• Communication - Shares thoughts and information in a clear, concise and professional manner, in both oral and written communication formats. Demonstrates active listening and seeks further information to ensure clarity and understanding. Promptly responds to requests for information.

Indiana University Health is unlike any other healthcare system and we're looking for team members who share the things that matter most to us. IU Health leaders play a crucial role in advancing the mission of our organization and inspiring teams to make a meaningful difference in the lives of patients. As one of Indiana's largest employers and the most comprehensive medical system in the state, our vision is to lead the transformation of healthcare through quality, innovation and education, and make Indiana one of the nation's healthiest states.

Our systems programs in cancer, cardiovascular, neuroscience, orthopedics, pediatrics and transplants have received national recognition for quality patient care. IU Health, in partnership with the Indiana University School of Medicine, bring together highly skilled physicians, researchers, and educators into close collaboration to provide world class care for children and adults and improve the health of patients and communities across Indiana.

Indiana University Health is dedicated to a fair hiring process and is committed to equal opportunity and nondiscrimination for all individuals, regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, gender identity, expression, sexual orientation, or veteran status.

We are an equal opportunity employer. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.