Credentialing Specialist

VIVA USA Inc; United States; Remote; USD 42,000 - 65,000; Full time

Job summary

VIVA USA Inc. is seeking a Credentialing Specialist to guide clinicians through the client credentialing process in a fully remote U.S. environment.

You will assist with credentialing applications, perform primary source verifications, and maintain the MD Staff credentialing database, ensuring compliance with NCQA, URAC, and state/federal requirements. Responsibilities include reviewing credentialing and re-credentialing files, maintaining licenses and certifications, coordinating with the

Qualifications

• 1-3 years of successful work experience in a credentialing role/department.
• Familiar with NCQA accreditation standards.
• Demonstrate active listening and the ability to provide/receive feedback.
• Strong interpersonal skills to build rapport with stakeholders.
• Proficient with Google Suite and credentialing systems.

Responsibilities

• Review and process credentialing and re-credentialing files.
• Establish and maintain a system for timely processing of credentialing files per NCQA policies.
• Query organizations and evaluate responses to ensure NCQA standards compliance.
• Maintain copies of current state licenses, DEA, malpractice coverage, and other credentialing docs.
• Review background checks, drug tests, and TB screenings and record results.
• Assemble verified information and prepare files for Credentialing Committee.
• Verify providers’ requirements for approval to work in specific states/plans.
• Assist with ongoing monitoring of contracted clinicians.
• Use MD Staff credentialing database to run queries, generate reports, and improve efficiency.
• Provide administrative support to department leadership and stakeholders.
• Maintain professionalism and timely responses to emails.
• Demonstrate teamwork and assist with special projects.
• Protect PHI and ensure privacy during work activities.

Skills

Credentialing experience

Active listening

Interpersonal skills

Time management

Communication skills

Education

High school diploma or equivalent

Tools

Google Suite

MD Staff system

Job description

Fully remote

Position Summary

The Credentialing Specialist ensures clinicians successfully pass the clientcredentialing process. This role is responsible for assisting clinicians with the completion of their credentialing applications , performing primary source verifications , and maintaining the MD Staff credentialing database. The Specialist must ensure all credentialing functions comply with internal policies, client health plan contracts, URAC guidelines, NCQA standards, and applicable state and federal requirements. This position reports to the Credentialing Supervisor.

Key Responsibilities

• Review and process credentialing and re-credentialing files.
• Establish and maintain a system for the timely processing of credentialing files in accordance with NCQA policies.
• Query appropriate organizations and evaluate responses to ensure provider compliance with NCQA standards.
• Maintain copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for all providers.
• Review all background checks, drug tests, and TB screenings and record the results.
• Assemble all verified information and prepare files for presentation to the Credentialing Committee.
• Verify providers’ requirements for approval to work in specific states and plans.
• Assist with the ongoing monitoring of contracted clinicians.
• Utilize the MD Staff credentialing database to perform queries, generate reports, and optimize efficiency.
• Provide administrative support to department leadership and both internal and external stakeholders.
• Maintain professionalism at all times 17and provide timely, professional responses to all emails.
• Actively demonstrate teamwork and assist with special projects.
• Responsible for the security and privacy of any protected health information (PHI) accessed during work activities.

Required Qualifications

• 1-3 years of successful work experience in a credentialing role/department.
• Intermediate skills with Google Suites.
• Must be familiar with NCQA accreditation standards.
• Demonstrate active listening skills and the ability to provide and receive constructive feedback
• Strong interpersonal skills, with the ability to build rapport and productive relationships with internal and external stakeholders

Preferred Qualifications

• Obtain NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) within 2 years of eligibility to certify.
• Working knowledge of problem-solving and decision-making skills.
• Ability to organize and prioritize workload and day‑to‑day tasks.

Education

High school diploma or up to 1 year of equivalent experience.

Top Required Skills

• 1. Medical Staff Credentialing Experience
• Minimum 1–3+ years of credentialing experience required
• Strong preference for medical staff (hospital‑based) credentialing
• NOT targeting provider enrollment backgrounds (Medicare/Medicaid/payer enrollment)

Primary Source Verification (PSV)

• Must have hands‑on experience completing PSV, including:
• State licenses
• DEA
• Malpractice coverage
• Background checks and screenings

NCQA Knowledge & Compliance

• Working knowledge of NCQA standards
• Ability to maintain compliance and ensure accuracy of credentialing files

Google Suite & Systems Proficiency (CRITICAL)

• Must be comfortable using:
• Google Sheets, Docs, Gmail
• Experience working within credentialing systems (MD Staff or similar strongly preferred)
• Strongly Preferred
• 2–5 years total credentialing experience
• Experience in hospital or health system environments
• Experience preparing files for credentialing committee review
• MD Staff system experience
• NAMSS/CPCS certification (not required)

Candidate Profile – What “Good” Looks Like

• Has processed credentialing files independently
• Strong attention to detail and compliance accuracy
• Able to manage multiple files and meet deadlines
• Comfortable working in a fast‑paced, remote environment
• Demonstrates strong communication and organizational skills

Work Schedule

7:30 AM – 4:30 PM CST

Fully remote (U.S.)

VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status