Credentialing & Compliance Specialist

Primary Health Solutions; Ohio; On-site; USD 42,000 - 60,000; Full time

Job summary

Primary Health Solutions is seeking a Credentialing Specialist to coordinate initial credentialing, recredentialing, and licensure verification for a range of licensed clinical staff. You will ensure compliance with HRSA, CMS, state boards, and payer requirements, maintaining accurate records throughout the employment lifecycle.

This role does not perform payer enrollment or revenue cycle duties and requires strict confidentiality and attention to detail in a fast-paced environment.

Qualifications

• High school diploma or GED required; associate degree preferred.
• Minimum 2 years credentialing experience in healthcare preferred.
• Experience in FQHC hospital, medical group, or healthcare organization preferred.
• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management preferred.

Responsibilities

• Coordinate initial credentialing and recredentialing for licensed clinical personnel.
• Perform primary source verification for licenses, credentials, board certifications, and related items.
• Maintain credentialing files in compliance with regulatory requirements.
• Monitor license and certification expirations and notify leadership of upcoming renewals.
• Assist providers with credentialing applications and paperwork, collecting signatures as needed.

Skills

Attention to detail

Regulatory compliance

Communication

Education

High school diploma or GED

Associate degree or higher

Tools

Electronic medical record

Microsoft Word

Job description

Primary Health Solutions is seeking a Credentialing Specialist to coordinate initial credentialing, recredentialing, and licensure verification for a range of licensed clinical staff. You will ensure compliance with HRSA, CMS, state boards, and payer requirements, maintaining accurate records throughout the employment lifecycle.

This role does not perform payer enrollment or revenue cycle duties and requires strict confidentiality and attention to detail in a fast-paced environment.