Credentialing Specialist

Banner Health; Carson City (NV); Remote; USD 60,000 - 80,000; Full time

Job summary

Join a leading healthcare provider as a Credentialing Specialist, fully remote and focused on maintaining the integrity of credentialing processes. You will manage essential documentation and collaborate with healthcare professionals, contributing to optimal patient and organizational outcomes.

Qualifications

• Strong knowledge of healthcare and credentialing processes.
• Experience interacting with healthcare professionals.
• Ability to maintain confidentiality and manage sensitive information.

Responsibilities

• Process initial and re-credentialing files to ensure compliance.
• Update tracking systems and manage status updates.
• Handle physician inquiries and maintain accurate records.

Skills

Communication

Organization

Judgment

Education

Associate's degree

Tools

Data entry

Spreadsheet software

Job description

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Estimated Pay Range:

$21.01 - $31.51 / hour, based on location, education, & experience.

Department Name:

Credentialing

Work Shift:

8 hours

Job Category:

Clinical Support

Estimated Pay Range:

$21.01 - $31.51 / hour, based on location, education, & experience.

In accordance with State Pay Transparency Rules.

Banner Health was recently recognized on Forbes inaugural list of America’s Dream Employers 2025. This list highlights employers across the country that prioritize workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of their employees.

Banner Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs while keeping our members in optimal health. BPN is known for its innovative, collaborative, and team-oriented approach to healthcare. We offer diverse career opportunities, from entry-level to leadership positions, and extend our innovation to employment settings by including remote and hybrid opportunities.

As a Credentialing Specialist, you will handle the processing of initial and re-credentialing files, reach out for additional items needed, and run any expired items needed for the file to be compliant when going to committee. You will also update providers due for credentialing and re-credentialing into the tracking system and update the status along the way through to credentials committee and upload files as needed.

The position is fully remote, with work hours from Monday to Friday during standard business hours according to the Arizona Time Zone. If you're interested in this role, we encourage you to apply today!

This is a fully remote position and available if you live in the following states only: AZ, CA, CO, NE, NV, and WY. This position is fully remote with travel less than 15% of the time to either a Banner corporate or hospital site. With this remote work, candidates must be self-motivated, possess moderate to strong tech skills and be able to meet daily and weekly productivity metrics.

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

Position Summary

This position performs the department's credentialing work as outlined in the policies and procedures. Obtains all primary source information necessary for all organizational facilities and entities. The incumbent maintains records and the integrity of highly confidential information that is protected from discovery by applicable state statutes.

Core Functions

• Performs the appropriate (applicable) credentialing processes in a timely and complete manner.
• Performs analysis and appropriate follow-up. Works with many individuals to acquire necessary materials and information, including, but not limited to: physicians, facility staff, professional staff and physicians’ office staff.
• Performs relevant data entry into the database to ensure consistency and integrity of the data.
• Processes appropriate queries for expired licensure, or any appropriate regulatory credentialing requirement and maintains documentation in the database.
• The incumbent performs and completes activities within the parameters established by the director and supervisor and as outlined in the facility/entity documents. Manages own duties and functions independently. Work requires the constant exercise of a high degree of independent judgment in response to complex and sensitive credentialing issues, decision making and discretion. Uses independent decision making processes and handles assigned duties in a meaningful and confidential manner with a minimum of supervision. Handles physician inquiries and problems within the scope of job function and keeps supervisors apprised of all issues as they occur. Department and hospital responsibility. Internal customers include facility medical staff services, physicians, hospital personnel, corporate staff, hospital management, and volunteers. External customers include but are not limited to regulatory/accrediting and licensing agencies, legal entities, state and national databases, other hospitals and the general public.
  
  

Minimum Qualifications

Must possess a strong knowledge of business and/or healthcare as normally obtained through the completion of an associate’s degree.

Must possess a strong knowledge and understanding of healthcare planning as normally demonstrated through three years of credentialing and/or process management and operations experience. Requires a basic knowledge of medical terminology, medical staff organization and extensive knowledge of credentialing procedures. Must have experience in interacting with physicians and allied health professionals, their office credentialing representatives, and hospital personnel.

Must have excellent communication skills, both verbal and written, along with astute judgment in areas of human relations. Must demonstrate an ability to meet deadlines in a multi-functional task environment. Requires excellent organizational skills and operational knowledge working with work processing, spreadsheets, data entry, fax machines, and other computer related skills. Must, at all times, maintain efficiency and timeliness in all daily activities. Must be able to establish daily work priorities and work efficiently to contribute to the successful overall maintenance of the credentialing process. Provides optimal customer service to meet the organization’s expectations.

Preferred Qualifications

National Certified Provider Credentialing Specialist (NCPCS) certification preferred.

Additional Related Education And/or Experience Preferred.

Anticipated Closing Window (actual close date may be sooner):

2025-09-26

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

Privacy Policy:

Privacy Policy

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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