Credentialing Specialist

RCA - Recovery Centers of America Management Company; United States; On-site; USD 33,000 - 52,000; Part time

Job summary

RCA - Recovery Centers of America Management Company is seeking a part-time Credentialing Specialist to support licensure, certifications, and payer credentialing tasks. This role ensures required documentation is accurate, up to date, and processed according to procedures, regulatory requirements, and organizational standards.

Under the Credentialing Manager, you will review onboarding documents, prepare applications, track statuses, perform primary source verifications, create CAQH profiles,

Qualifications

• High school diploma required; Associate's degree preferred.
• Healthcare or credentialing experience preferred.
• Knowledge of CAQH and credentialing processes preferred.
• Attention to detail and organizational skills.
• Ability to manage multiple tasks and meet deadlines.
• Strong written and verbal communication skills.
• Proficiency in Microsoft Office and database systems.

Responsibilities

• Review onboarding and credentialing documentation for completeness and accuracy.
• Prepare and submit credentialing and recredentialing applications.
• Track status and log pending/completed submissions.
• Follow up with payers, providers, and internal stakeholders.
• Monitor upcoming license, certification, credential expirations.
• Perform primary source verification and registry checks.
• Create and maintain CAQH profiles and ensure data accuracy.
• Enter credentialing data in internal systems.
• Assist with audits, roster reconciliations, and compliance reporting.
• Support onboarding and offboarding credentialing activities.
• Communicate credentialing status updates to stakeholders.

Skills

Attention to detail

Organizational skills

Multitasking

Written and verbal communication

Microsoft Office

Database systems

CAQH knowledge

Healthcare credentialing experience

Education

High school diploma

Associate's degree preferred

Tools

CAQH

Microsoft Office

Database systems

Job description

The Credentialing Specialist (Part-Time) supports the credentialing function by performing administrative and operational tasks related to employee licensure, certifications, and payer credentialing processes. This role ensures that required documentation is accurate, up to date, and processed in accordance with established procedures, regulatory requirements, and organizational standards.

This position follows defined workflows and works under the direction of the Credentialing Manager.

Key Responsibilities

• Review onboarding and credentialing documentation for completeness and accuracy.
• Prepare and submit credentialing and recredentialing applications for providers and facilities.
• Track application status and maintain detailed logs of pending and completed submissions.
• Conduct follow-up with payers, providers, and internal stakeholders regarding application status.
• Monitor and notify providers of upcoming license, certification, and credential expirations.
• Perform primary source verification and registry checks in accordance with established requirements.
• Create and maintain CAQH profiles and ensure all data is accurate and current.
• Enter and maintain credentialing data in internal systems with a high level of accuracy.
• Assist with audits, roster reconciliations, and compliance-related reporting.
• Support onboarding and offboarding credentialing activities.
• Communicate credentialing status updates to appropriate stakeholders.

Operational Scope

• Performs work based on established procedures, guidelines, and workflows.
• Escalates issues, delays, or compliance concerns to the Credentialing Manager.

Knowledge, Skills, and Education

• High school diploma required; Associate's degree preferred.
• Prior healthcare or credentialing experience preferred.
• Working knowledge of CAQH and credentialing processes preferred.
• Strong attention to detail and organizational skills.
• Ability to manage multiple tasks and meet deadlines.
• Strong written and verbal communication skills.
• Proficiency in Microsoft Office and database systems.

Professional office environment with routine use of standard office equipment.

Physical Demands

Standard office-related physical requirements, including sitting, typing, and occasional lifting up to 25 pounds.

Schedule & Travel

• Part-time schedule based on business needs
• Minimal to no travel required

Work Days

Monday-Friday

Work Shift

1st

Shift Hours

variable

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