Credentialing Specialist

Banner Health; Colorado; Remote; Full time

Job summary

A leading healthcare organization is seeking a Credentialing Specialist who will be responsible for maintaining the integrity of credentialing processes for healthcare providers. This remote position requires strong organizational skills and a solid understanding of healthcare regulations. Ideal candidates will have experience in credentialing and excellent communication abilities, contributing towards personalized patient care and efficiency in operations.

Qualifications

• Strong knowledge of healthcare and credentialing processes.
• Three years of experience in credentialing or process management.
• Excellent verbal and written communication skills.

Responsibilities

• Perform primary source verification of providers’ credentials.
• Maintain records of confidential information related to credentialing.
• Analyze responses and documentation related to credentialing.

Skills

Communication

Organizational Skills

Attention to Detail

Education

Associate’s Degree

Tools

Data Entry Software

Spreadsheets

Job description

Department Name:

BH Central Verificatn Ofc-Corp

Work Shift:

Day

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 recognized on Becker's Healthcare 2025 list of 150+ top places to work in healthcare. This recognition highlights our commitment to supporting team members through comprehensive benefits, opportunities for both personal and professional growth, inclusive and empowering work environments, and resources that promote a healthy work-life balance.

In this role as a Credentialing Specialist, you will be providing database maintenance and processing of applications for all providers. You will be responsible for primary source verification of initial and reappointment applications in addition to monitoring documents due to expire, e.g. license, DEA, insurance, board certification for physicians and allied health professionals. Ideally, you will have experience credentialing providers for hospital privileges.You will be working with a cohesive team in a high-volume department. Daily tasks include: communicating via phone and email, data entering information into credentialing database, obtaining primary source verifications, analyzing responses and documentation.

This position is Remote with a preference for candidates in Arizona and Colorado. The schedule is Monday - Friday 8-hour days with some flexibility.

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

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
1. Performs the appropriate (applicable) credentialing processes in a timely and complete manner.

2. 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.

3. Performs relevant data entry into the database to ensure consistency and integrity of the data.

4. Processes appropriate queries for expired licensure, or any appropriate regulatory credentialing requirement and maintains documentation in the database.

5. 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):

2025-10-16

EEO Statement:

EEO/Disabled/Veterans

Our organization supports a drug-free work environment.

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