Credentialing Specialist

Western University of Health Sciences

Pomona (CA)

On-site

USD 52,000 - 58,000

Full time

14 days+

Get more replies from employers

Send a job-specific resume in minutes.

Benefits offered by this job

Competitive salaries

Generous paid time off

Insurance plans

Retirement benefits

Supportive working environment

Job summary

Western University of Health Sciences is seeking a Credentialing Specialist to provide essential support for healthcare operations, managing the credentialing and recredentialing of providers. This is a full-time position based at the Pomona campus.

The ideal candidate will possess a solid understanding of credentialing processes and regulatory standards, with strong organizational skills and attention to detail. Join us at WesternU, where we value humanistic care in every interaction.

Qualifications

Minimum of two years of relevant experience in provider credentialing.

Responsibilities

Reviews and screens credentialing applications for compliance.
Prepares documents for primary source verification process.
Identifies and resolves discrepancies impacting credentialing.

Skills

Strong working knowledge of healthcare provider credentialing process

Experience with Excel, Word, Outlook, SharePoint

Knowledge of regulatory requirements and accreditation standards

Familiarity with credentialing management applications

Strong interpersonal and communication skills

Ability to establish daily work priorities

Attention to detail and good organization

Ability to handle multiple tasks

Commitment to humanistic values

Education

High School Diploma or equivalent

Tools

Credentialing management applications (e.g., Verity Stream)

Job description

As you take your first step onto a Western University of Health Sciences campus, each path, each person, each structure comes with a transformative story. WesternU is more than the practice of medicine. We are defined by character and culture. At WesternU, you will discover humanism at the heart of every interaction: a warm welcome, a sincere smile, a positive word, a kind deed, a thoughtful gesture. You will see students work together on case studies, a parade of pets in campus parks, student clubs offering opportunities for career growth and community involvement, and faculty, staff and students designing their future and the future of WesternU. We display a collaborative mindset in how we operate, educate, and serve others. Although, geographically, we are two campuses – as humanists, we are one: to enhance and extend the quality of life in our communities and achieve excellence in everything we do. We attract diverse, professional faculty, staff and students that thrive in an environment of humanistic health care education. Join our team of faculty and staff and make a difference.

Position Title: Credentialing Specialist

Position Control Number: 100455

Type of Position: Staff

Position Status: Full-time

Campus: Western University Campus-Pomona, CA

Position Location: California

Department: 1313-Patient Care Center - PCC

Job Summary

Provides integral support to healthcare operations by enabling timely onboarding of healthcare providers through the evaluation, analysis, and coordination of all aspects of the credentialing and recredentialing processes for practitioners practicing within the WesternU Health System clinical entities.

Knowledge, Skills and Abilities

Strong working knowledge of healthcare provider credentialing process
Experience working with Windows based applications: Excel, Word, Outlook, SharePoint
Significant knowledge of State and Federal Regulatory requirements and accreditation standards, e.g., NCQA, NPDB, Title XXII, CAQH and NPPES related to healthcare provider credentialing
Considerable working knowledge of credentialing management applications, e.g., Verity Stream
Strong customer focus, interpersonal, collaboration, written/verbal communication, prioritization, and computer skills
Must be able to establish daily work priorities and work efficiently to contribute to the successful overall maintenance of the credentialing process.
Demonstrated attention to detail and good organizational capability.
Able to handle multiple simultaneous tasks and complete work projects in designed time frames.
Demonstrate a commitment to working in an organization that values and promotes humanism.

Required Qualifications

Education: High School Diploma or equivalent.
Experience: Minimum of two years of relevant experience in provider credentialing.

Preferred Qualifications

Experience: A background in clinical academic setting is highly preferred.
Preference will be given to individuals with NAMSS Certification as Certified Provider Credentialing Specialist (CPCS).

Key Responsibilities

Reviews and screens initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal, state, local and University regulations, guidelines, policies, and standards.
Prepares documents for primary source verification process, collects, and validates documents to ensure accuracy of all credentialing elements.
Assesses completeness of information and qualifications relative to credentialing standards and WesternU Health System criteria.
Identifies, analyzes, and resolves extraordinary information, discrepancies, time gaps and other peculiarities that could adversely impact ability to credential and enroll practitioners.
Discovers and conveys problems to Executive Director University Compliance and Chair of Provider Credentialing Committee for sound decision making in accordance with credentialing policies and procedures, federal, state, local and government/insurance agency regulations.
Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies.
Prepares and provides information to internal and external customers as appropriate.
Enters, updates, and maintains data from provider applications into credentialing database, focusing on accuracy, and interpreting or adapting data to conform to defined data field uses, and in accordance with internal policies and procedures.
Submits and responds to requests for required documentation to third‑party payors for credentialing/recredentialing.
Prepares, issues, electronically tracks and follows‑up on appropriate verifications for efficient, high‑volume processing of individual applications in accordance with applicable credentialing standards, established procedural guidelines, and strict timelines.
Participates in the development and implementation of process improvements for the system‑wide credentialing process.
Prepares reports and scoring required by regulatory and accrediting agencies, policies, and standards.
Communicates clearly with providers, their liaisons, Clinical Deans and WesternU Health Administration, as needed to provide timely responses upon request on day‑to‑day credentialing and privileging issues as they arise.
Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest developments to enhance understanding of various regulations and legislation of the health care industry.
Performs miscellaneous job‑related duties as assigned.

Work Schedule

Monday‑Friday, 8 AM – 5 PM.

Benefits Summary

We offer competitive salaries, generous paid time off, insurance plans, reimbursements, and retirement benefits. Our faculty, staff and administrators are 100% focused on student success. Our University culture creates the context for a nurturing and supportive environment. Faculty, staff, and students can expect to make deep, personal relationships within the University community. As a Faculty, Staff, or Student at WesternU, you can focus on work that you love, be your authentic self, and lead to the future with innovation in health sciences. WesternU’s core value of humanism encourages all to bring their whole self in all that they do. We are committed to fostering a culture of respect, equity, collaboration, and fun at all levels for all people.

Expected Pay Scale

Minimum: $25.00 Hourly

Maximum: $28.00 Hourly

Physical Demands

The essential functions of this job require lifting. The employee is regularly required to stand, walk, and carry up to 25 pounds. The employee is frequently required to use hands, reach with hands and arms, and stoop.

Work Environment

Duties are normally performed in a typical office setting. Occasionally the employee is exposed to outdoor weather and road conditions. The noise level in this setting is usually low to moderate.

Posting Information

Posting Number: S01709
Posting Date: 10/15/2025
Close Date: 10/15/2026
Open Until Filled: Yes

Conditions of Employment – Background Check

To secure employment, successful fulfillment of a background check, including a criminal records check, may be required. Western University of Health Sciences will extend a conditional offer of employment, subject to rescission if the background check unveils disqualifying information or if it is found that the candidate deliberately withheld or misrepresented information. Non‑completion of the background check to satisfaction may impact the ongoing employment of a current Western University of Health Sciences employee who received a conditional offer for the position.

Pay Transparency Act

Western University of Health Sciences is required to provide a reasonable estimate of the compensation range for this role. This range considers various factors in making compensation decisions, including but not limited to experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. It is not typical for an individual to be offered a salary at or near the top of the range for a position. Salary offers are determined based on final candidate qualifications and experience. The Expected Pay Scale is defined as the budgeted salary or hourly range that the University reasonably expects to pay for this position. Placement within the Expected Pay Scale is determined by internal equity and relevant qualifications.

Equal Opportunity Statement (EEO)

It is the policy of Western University to provide equal employment opportunity to all employees and applicants for employment as required by law without regard to age, race, color, national origin ancestry, citizenship, ethnicity, creed, religion or religious creed, sex or gender (including gender identity), marital status, sexual orientation, disability (both physical and mental) including HIV and AIDS, medical condition (cancer and genetic characteristics), pregnancy (which includes childbirth, breastfeeding and medical conditions related to pregnancy, childbirth or breastfeeding), age, genetic information, military and veteran status, or any other applicable protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within WesternU including without limitation, hiring, recruiting, promotion, termination, layoffs, leave of absence, compensation, benefits, and training. WesternU makes hiring decisions based solely on qualifications, merits, and business needs at the time.

Required Documents