Credentialing Specialist

Greenkey Resources LLC; New York (NY); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Greenkey Resources LLC is seeking a Credentialing Specialist to oversee clinical staff credentialing, ensuring compliance with healthcare regulations and organizational standards. This hybrid role requires two onsite days weekly to foster collaboration and teamwork.

You will support onboarding and credentialing activities, manage CAQH and MD-Staff records, participate in audits, and collaborate with HR and leadership to maintain accurate, audit-ready credentialing documentation.

Qualifications

• High School Diploma or GED required; Associate's or Bachelor's degree preferred.
• Minimum of three years of healthcare credentialing experience; four years preferred.
• Proficiency in credentialing systems such as CAQH, MD-Staff, or similar platforms.
• Strong organizational and time management skills to handle multiple priorities effectively.
• Experience with compliance documentation, audits, and regulatory reviews preferred.
• Excellent communication skills to liaise with internal and external stakeholders.
• Ability to maintain confidentiality and accuracy in credentialing documentation.
• Familiarity with healthcare regulations and credentialing standards highly desirable.
• Certifications such as SHRM or HRCI are preferred but not mandatory.

Responsibilities

• Coordinate initial credentialing and recredentialing processes for clinical staff, ensuring timely completion.
• Collect, review, and maintain credentialing documentation, ensuring accuracy and compliance.
• Utilize credentialing systems like CAQH and MD-Staff to manage records and track expirations.
• Support primary source verification activities and maintain audit-ready documentation.
• Collaborate with HR and clinical leadership to address credentialing requirements and resolve discrepancies.
• Assist with onboarding processes by communicating credentialing needs to new hires and stakeholders.
• Monitor compliance with licensing, certifications, and regulatory requirements for clinical personnel.
• Participate in audits, regulatory reviews, and quality assurance initiatives related to credentialing.
• Provide administrative support for HR projects, meetings, and compliance documentation.

Job description

Credentialing Specialist Overview

• The Credentialing Specialist will oversee clinical staff credentialing processes, ensuring compliance with healthcare regulations and organizational standards.
• This hybrid position requires two onsite days weekly, providing flexibility and collaboration opportunities.
• Support onboarding and credentialing activities, including initial credentialing, recredentialing, and documentation management.
• Collaborate with internal stakeholders and external credentialing partners to ensure timely completion of credentialing requirements.
• Maintain accurate credentialing records using systems such as CAQH, MD-Staff, and OCHIN.
• Assist with compliance initiatives, audits, and regulatory reviews to uphold organizational standards.
• Provide administrative support to the Human Resources department, enhancing operational efficiency.
• Contribute to process improvements and quality assurance within credentialing workflows.
• Ideal for professionals with healthcare credentialing experience seeking a dynamic and impactful role.

Credentialing Specialist Key Responsibilities & Duties

• Coordinate initial credentialing and recredentialing processes for clinical staff, ensuring timely completion.
• Collect, review, and maintain credentialing documentation, ensuring accuracy and compliance.
• Utilize credentialing systems like CAQH and MD-Staff to manage records and track expirations.
• Support primary source verification activities and maintain audit-ready documentation.
• Collaborate with HR and clinical leadership to address credentialing requirements and resolve discrepancies.
• Assist with onboarding processes by communicating credentialing needs to new hires and stakeholders.
• Monitor compliance with licensing, certifications, and regulatory requirements for clinical personnel.
• Participate in audits, regulatory reviews, and quality assurance initiatives related to credentialing.
• Provide administrative support for HR projects, meetings, and compliance documentation.

Credentialing Specialist Job Requirements

• High School Diploma or GED required; Associate's or Bachelor's degree preferred.
• Minimum of three years of healthcare credentialing experience; four years preferred.
• Proficiency in credentialing systems such as CAQH, MD-Staff, or similar platforms.
• Strong organizational and time management skills to handle multiple priorities effectively.
• Experience with compliance documentation, audits, and regulatory reviews preferred.
• Excellent communication skills to liaise with internal and external stakeholders.
• Ability to maintain confidentiality and accuracy in credentialing documentation.
• Familiarity with healthcare regulations and credentialing standards highly desirable.
• Certifications such as SHRM or HRCI are preferred but not mandatory.