Credentialing Specialist

CommonSpirit Health; Omaha, Northern (NE, KY); Hybrid; USD 42,000 - 66,000; Full time

Job summary

CommonSpirit Health is seeking a Credentialing Specialist in Omaha, NE to manage the full lifecycle of provider credentialing and re-credentialing. You will ensure compliance with The Joint Commission, NCQA, URAC, and CMS, perform primary source verifications, conduct background checks, generate reports, and support audits in a fast-paced healthcare admin environment.

Effective communication and data accuracy are essential as you coordinate with clinics, hospitals, and medical staff offices to

Qualifications

• Strong working knowledge of medical credentialing standards and hospital operations.
• Analytical skills to interpret research findings and manage confidential information.
• Proficiency in database management and report generation.

Responsibilities

• Coordinate end-to-end credentialing and re-credentialing for providers.
• Conduct background investigations and primary source verifications.
• Generate credentialing reports and track eligibility; support delegated credentialing audits.
• Serve as a point of contact for internal and external stakeholders and resolve discrepancies.

Skills

Credentialing standards

Analytical skills

Database management

Report generation

Communication

Education

High School GED General Studies

High School Graduate General Studies

Job description

Job Summary and Responsibilities

As our Credentialing Specialist, you will play a pivotal role in maintaining the accuracy and integrity of our healthcare provider data. You will be responsible for coordinating the end-to-end credentialing and re-credentialing process for the CHI Health System. By ensuring strict compliance with regulatory bodies such as The Joint Commission, NCQA, URAC, and CMS, you will support our commitment to high-quality care and medical staff excellence.

Every day you will manage the full lifecycle of practitioner files, from initial appointment and clinical privileging to ongoing expirables monitoring. Your tasks will include conducting thorough background investigations, performing primary source verifications, and utilizing our credentialing database to generate reports and track eligibility. You will serve as a key point of contact for internal and external stakeholders, providing clear communication while resolving credentialing discrepancies and assisting with delegated credentialing audits.

To be successful in this role, you will bring a strong working knowledge of medical credentialing standards, hospital operations, and regulatory requirements. You must possess sharp analytical skills to interpret research findings and the ability to exercise independent judgment when handling confidential information. Proficiency in database management and report generation is essential, alongside a dedication to professionalism and the ability to effectively manage competing priorities in a fast-paced healthcare administrative environment.

Job Requirements

• High School GED General Studies, upon hire or
• High School Graduate General Studies, upon hire

Where You'll Work

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based care and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community.