Credentialing & Compliance Champion

Mercy Health; United States; Vor Ort; USD 52.000 - 65.000; Vollzeit

Benefits dieser Stelle

Competitive pay

Medical/dental/vision

PTO & leave

Tuition assistance

Zusammenfassung

Mercy Health is seeking a Credentialing Specialist to manage provider applications, data collection, and primary source verification for our CVO. This role supports onboarding and offboarding, follows standard procedures, and emphasizes quality, reliability, and excellent service.

You will maintain provider databases, prepare files for Medical Director review, and stay current with TJC, NCQA, and CMS guidelines while safeguarding privacy and confidentiality.

Qualifikationen

• High School or GED required; a Bachelor's degree preferred.
• Bachelor’s or Master’s degree in Business/Healthcare preferred.
• 1 year recent experience in medical staff services or CVO setting preferred.

Aufgaben

• Credentialing application processing and primary source verification per regulatory standards.
• Prepare files for Medical Director review and MSO committees; correct deficiencies with auditors.
• Maintain provider data and ensure timely credentialing workflows and quality metrics.
• Stay current with TJC, NCQA, CMS and other regulatory guidelines; protect privacy.

Ausbildung

High School or GED

Bachelor's Degree in Business/Healthcare

Master's Degree in Business/Healthcare

Tools

Credentialstream

Jobbeschreibung

Mercy Health is seeking a Credentialing Specialist to manage provider applications, data collection, and primary source verification for our CVO. This role supports onboarding and offboarding, follows standard procedures, and emphasizes quality, reliability, and excellent service.

You will maintain provider databases, prepare files for Medical Director review, and stay current with TJC, NCQA, and CMS guidelines while safeguarding privacy and confidentiality.