A5 Healthcare (Anders Affiliate) one of the fastest-growing Credentialing Verification Organizations in the country is seeking a Credentialing Specialist who is motivated to learn, excited to collaborate and passionate about delivering outstanding results. This individual will have a direct impact on our firm’s mission of serving as a catalyst for those striving to achieve their highest potential.
What You’ll Do
Credentialing Operations
- Perform comprehensive application management, including requesting, receiving, processing, and verifying initial and reappointment applications.
- Conduct preliminary analysis of application data and verification information to identify any red flags or adverse findings.
- Monitor expiring provider data such as professional licenses, DEA registrations, board certifications, and malpractice insurance.
- Communicate timely updates to providers and member organizations regarding application status and outstanding requirements.
- Prepare credentialing files accurately and submit them for facility audits and approvals in accordance with turnaround standards.
- Maintain working knowledge of relevant accreditation and regulatory standards (TJC, AAAHC, DNV, NCQA, and CMS).
- Assist with continuous improvement of credentialing workflows, including process alignment and development of forms.
- Participate in special projects and team initiatives as assigned.
General Responsibilities
- Maintain credentialing documentation and records with accuracy and confidentiality.
- Follow organizational policies and elevate issues beyond scope as needed.
- Collaborate effectively with CVO leadership and credentialing team members.
- Attend training sessions and professional development meetings to stay current with industry best practices.
Competencies
- Decision Making: Uses general instructions and established practices to make decisions; may recommend improvements to moderately complex issues.
- Problem Solving: Analyzes and interprets varied situations to resolve credentialing issues based on industry knowledge and precedent.
- Independence of Action: Follows established policies, organizes work effectively, and seeks guidance for complex or unusual scenarios.
- Written & Oral Communications: Communicates clearly with providers and facilities; explains credentialing requirements effectively.
- Knowledge Application: Demonstrates working knowledge of credentialing procedures and applies them accurately in day-to-day tasks.
- Team Collaboration: Engages in teamwork to support department objectives, share knowledge, and contribute to continuous improvement.
What We’re Looking For
- Strong documentation and analytical skills with high attention to detail.
- Ability to interpret and apply credentialing standards and regulatory guidelines.
- Excellent verbal and written communication skills.
- Proven ability to organize, prioritize, and manage multiple responsibilities.
- Capacity to work independently and in a team-based remote environment.
- Sound problem‑solving and decision‑making capabilities.
- Commitment to confidentiality and professional ethics.
Your Qualifications
- High school diploma or GED required.
- 1–3 years of relevant credentialing experience, preferably within a CVO or similar setting.
- Proficiency with Microsoft Office applications (Word, Excel, Outlook) and web‑based systems.
- Knowledge of credentialing software platforms and auditing processes preferred.
Applicants to the Credentialing Specialist position must be located within the Greater St. Louis, MO area.
Salary Range: $43,680—$56,160 USD
All applicants for this position must be authorized to work in the United States now and in the future without requiring sponsorship.