Credentialing Specialist (Full Time)

Community Care Alliance; Woonsocket (RI); On-site; USD 48,000 - 64,000; Full time

Benefits offered by this job

Vacation & holidays

Medical & dental

Vision coverage

AFLAC coverage

403b plan

FSA & DCA

Life insurance

Licensure bonuses

Referral program

Parking & mileage

Job summary

Community Care Alliance is seeking a Credentialing Specialist for a full-time on-site role to coordinate, administer, and maintain credentialing for all eligible staff. You will collaborate with the HR team to assist with CEUs and training processing.

The position requires at least 1 year of credentialing experience in a healthcare setting, strong organizational skills, and excellent communication to support staff from new hires to executive management.

Qualifications

• Must have at least 1 year of credentialing and office experience in a health care setting.
• Minimum of high school diploma or equivalent.
• Ability to work in a fast-paced environment while remaining organized and handling multiple priorities simultaneously.
• Ability to work with a small but dynamic HR team.
• Excellent communication skills and ability to build strong relationships with employees from new hires to executive management.
• Flexible with strong problem-solving skills.

Responsibilities

• Complete all credentialing and re-credentialing duties and applications for agency.
• Maintain, track and follow up on licensure, certification, and credentialing documentation as required.
• Work with finance to ensure timely processing of salary increases/bonuses for new credential qualifications.
• Adhere to credentialing requirements of insurance/funding sources and provide initial documentation and renewals.
• Act as liaison between staff and insurance companies regarding credentialing correspondence.
• Work with billing to ensure proper reimbursements.
• Maintain up-to-date copies of staff licenses, certifications, DEAs, malpractice insurance and other provider information.
• Attend Billing Team meetings to discuss credentialing changes or issues.
• Provide reports for management to track credentialing progress.
• Participate on Training Committee and support CEU processing.
• Other HR duties as assigned.

Skills

Credentialing experience

Office experience

Communication skills

HR collaboration

Multitasking

Problem solving

Education

High school diploma

Job description

Credentialing Specialist (Full Time)

POSITION SUMMARY: Coordinate, administer and maintain credentialing process for all eligible staff. Work with HR team to assist with HR duties as needed, including participation with the agency training committee for processing of CEUs and special trainings.

QUALIFICATIONS:

• Must have at least 1 year of credentialing and office experience in a health care setting.
• Minimum of high school diploma or equivalent.
• Ability to work in a fast-paced environment while remaining organized and handling multiple priorities simultaneously.
• Ability to work with a small but dynamic HR team.
• Excellent communication skills and ability to build strong relationships with employees from new hires to executive management.
• Flexible with strong problem‑solving skills.

PRIMARY FUNCTIONS:

• Complete all credentialing and re‑credentialing duties and applications for agency.
• Assume full responsibility for maintaining, tracking and following up on any and all forms of licensure, certification, and credentialing documentation as required.
• Work with finance to ensure all specified monetary increases/bonuses for employees with new credential qualifications are processed in a timely manner.
• Adhere to the credentialing requirements of all insurance/funding sources for which they qualify and provide Human Resources with the initial required documentation (licenses, liability insurance policies, DEA numbers, etc.) and all renewals of these documents thereafter.
• Act as liaison between staff and insurance companies with regards to all credentialing correspondence.
• Work with billing team to ensure proper reimbursements are in place.
• Maintain up to date copies of staff licenses, certifications, DEAs, malpractice insurance and other provider information for credentialing and licensing.
• Attend Billing Team meetings to discuss any credentialing changes, updates or issues.
• Provide useful reports for management to be able to track where their staff are in the credentialing process.

SECONDARY FUNCTIONS:

• Participate on Training Committee and work to support CEU processing.
• Other HR duties as assigned.

Benefits

Community Care Alliance offers competitive salaries based on experience, skills and performance, a comprehensive benefits package, and great quality of work/life.

• Generous vacation, sick time and holidays.
• Comprehensive medical and dental coverage as well as voluntary vision and AFLAC supplemental coverage.
• 403b with matching after 6 months of employment.
• Flexible Spending (FSA) and Dependent Care (DCA) accounts.
• Agency‑paid group life insurance; long‑term disability.
• Tuition reimbursement and licensure/certification bonuses.
• Employee referral program as well as bilingual skills premium.
• On‑site or nearby parking available at most buildings; mileage reimbursement for client and business related use of your personal vehicle.

About Us

Community Care Alliance provides an array of services and supports that are linked together so people can access help for their unique situations. Our goal is to help all members of our community become healthier, more self‑reliant and better informed to meet their economic, social and emotional challenges.

Community Care Alliance is an Affir… All qualified applicants will receive consideration for employment without regard to race, religion, color, sex, sexual orientation, age, national origin, or disability.

Military friendly employer!