Credentialing Specialist — Hybrid/Remote

CVS Health; Dallas (TX); Hybrid; USD 23,000 - 39,000; Full time

Benefits offered by this job

Comprehensive benefits package

Job summary

CVS Health is hiring a Credentialing Specialist to support clinicians through the Signify Health credentialing process. You will assist with credentialing applications, perform primary source verifications, and maintain the MD Staff credentialing database.

This role requires adherence to NCQA standards and applicable state and federal requirements. You will report to the Credentialing Supervisor and collaborate with internal and external stakeholders while ensuring compliance and timely

Qualifications

• Requires 1–3 years in credentialing.
• Familiar with NCQA policies and accreditation standards.
• Strong communication and stakeholder management skills.

Responsibilities

• Review and process credentialing and re-credentialing files.
• Maintain system for timely processing of credentialing files per NCQA policies.
• Query organizations and verify provider compliance with NCQA standards.
• Maintain copies of licenses, DEA certificates, malpractice coverage and other documents.
• Review background checks, drug tests, and TB screenings and record results.
• Prepare files for Credentialing Committee review.
• Verify state/work eligibility for providers and plans.
• Support ongoing monitoring of contracted clinicians.
• Use the MD Staff credentialing database to run queries and generate reports.
• Provide administrative support to leadership and stakeholders.
• Respond professionally to emails in a timely manner.
• Demonstrate teamwork and support special projects.
• Protect PHI and ensure data security.

Skills

Active listening

Interpersonal skills

NCQA standards familiarity

Education

High school diploma or equivalent

Tools

Google Suites

Job description

CVS Health is hiring a Credentialing Specialist to support clinicians through the Signify Health credentialing process. You will assist with credentialing applications, perform primary source verifications, and maintain the MD Staff credentialing database.

This role requires adherence to NCQA standards and applicable state and federal requirements. You will report to the Credentialing Supervisor and collaborate with internal and external stakeholders while ensuring compliance and timely