Credentialing Specialist - Credentials

Bon Secours Mercy Health

Alaska

On-site

USD 52,000 - 76,000

Full time

4 days ago
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Benefits offered by this job

403(b) with employer contributions
Medical, dental, vision coverage
HSA/FSA options
Tuition assistance
Professional development

Job summary

Bon Secours Mercy Health is seeking a Credentialing Specialist for its Credentials Verification Organization. The role supports provider applications, PSV, onboarding/offboarding, and maintains compliant credentialing processes.

You will work with Medical Staff Office, credentialing committees and auditors to ensure timely, accurate files and ongoing regulatory adherence across Joint Commission, NCQA and CMS standards.

Qualifications

  • High School or GED required.
  • Bachelor's degree in Business, Healthcare or related field preferred.
  • Master's degree in Business, Healthcare or related field preferred.
  • 1 year recent experience in medical staff services or CVO setting preferred.
  • Certified Professional Medical Staff Management (CPMSM) or Certified Professional Credentials Specialist (CPCS) preferred.

Responsibilities

  • Follows standardized credentialing, application data collection and PSV processes.
  • Processes credentialing for new applicants and re-credentialing; resolves discrepancies.
  • Prepares files for Medical Director review and MSO; coordinates with credentialing auditors.
  • Maintains provider data and timely application processing to meet quality benchmarks.
  • Ensures provider database accuracy and regulatory compliance in PSV processes.
  • Keeps up-to-date with Joint Commission, NCQA, CMS and other guidelines via CVO education.
  • Communicates professionally with colleagues, MSO representatives and leadership.

Education

High School or GED
Bachelor's Degree in Business
Master's Degree in Business

Tools

CredentialStream Credentialing software

Job description

Credentialing Specialist - Credentials Verification Organization (CVO)

2026-08-15 Bon Secours Mercy Health all cities,AK

Description:

Thank you for considering a career at Bon Secours Mercy Health!

Scheduled Weekly Hours: 40

Work Shift: Days (United States of America)

Primary Function/General Purpose of Position

The Credentialing Specialist facilitates Credentials Verification Organization (CVO) provider application and data collection, application processing and Primary Source Verification (PSV) for the organization. Supports the organization's on-boarding and off boarding processes. This role follows established standard operating procedures and market specific medical staff bylaws and demonstrates exceptional customer service, communication, reliability and commitment to quality.

Essential Job Functions
  • Follows a standardized comprehensive credentialing application and data collection, application processing, and primary source verification processes that comply with all applicable regulatory standards.
  • Executes credentialing application and data collection, application processing, primary source verification for all new applicants and applicants for re-credentialing. Assures applications are correct, complete, resolves discrepancies in compliance with all applicable regulatory standards.
  • Assures files and documents are ready for Medical Director review, including all Credential Committees and Medical Staff Office (MSO). Works with the credentialing auditors to correct any deficiencies.
  • Organizes and maintains provider data and files. Processes applications timely and ensures that quality benchmarks are met with regards to turnaround times, accuracy of information and other CVO and regulatory metrics.
  • Assures that provider database is maintained with new and updated accurate provider information.
  • Follows all regulatory requirements related to the primary source verification process for medical staff and managed care compliance.
  • Completes credentialing compliance check points to assure that files are ready for release.
  • Maintains awareness of The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), Center for Medicare/Medicaid (CMS) and other regulatory compliance guidelines through the organization's CVO provided continuing education.
  • Demonstrates excellent professional communication skills while interacting with colleagues, customer relations and MSO representatives, and leadership to collect missing information or resolve issues.
  • Maintains a strong respect for privacy and confidentiality.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job . Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Licensing/Certification

Certified Professional Medical Staff Management (CPMSM) or Certified Professional Credentials Specialist (CPCS) by National Association of Medical Staff Services (NAMSS) (preferred)

Education
  • High School or GED (required)
  • Bachelor's Degree in Business, Healthcare or other related field (preferred)
  • Master's Degree in Business, Healthcare or other related field (preferred)
Work Experience

1 year recent experience in medical staff services or CVO setting (preferred)

Training

CredentialStream Credentialing software (strongly preferred)

Bon Secours Mercy Health is an equal opportunity employer.

As a Bon Secours Mercy Health associate, you're part of a Mission that matters. We support your well-being - personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What we offer
  • Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
  • Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts
  • Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
  • Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.

Department

SS Clinical Operations - Credentialing Verification

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health- Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affiritive Action and Equal Opportunity Employer, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com.

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