Credentialing Specialist: Provider Privileges & Compliance

Johnson-Health-Center; Madison Heights (VA); On-site; USD 50,000 - 65,000; Full time

Job summary

Johnson Health Center is seeking a Credentialing Specialist to join the administrative team. You will verify and organize credentialing and privileging files for providers and staff, perform primary source verifications, and keep credentialing software up to date.

You will collaborate with Compliance, HR, Billing, and CVO, monitor expiring licenses, and ensure timely responses to inquiries while upholding regulatory standards.

Qualifications

• 1+ years of credentialing experience with healthcare professionals.
• Knowledge of credentialing and privileging procedures and standards.
• Strong organizational skills.
• Excellent verbal and written communication skills.
• Proficient with Microsoft Office Word and Excel.

Responsibilities

• Process credentialing applications and verifications, including primary source verifications.
• Coordinate privileging forms and maintain provider files.
• Monitor expiring licenses, board certifications, and other credentials within required timeframes.
• Collect information from NPDB, malpractice insurer, and other sources as needed.
• Maintain credentialing software and ensure data accuracy and timely follow-ups.
• Collaborate with Compliance, HR, Billing, and Central Verification Officer to ensure smooth handoffs in the credentialing process.

Skills

Credentialing experience

Organizational skills

Verbal and written communication

Attention to regulatory standards

Education

High school diploma / GED

Tools

Microsoft Word

Excel

Job description

Johnson Health Center is seeking a Credentialing Specialist to join the administrative team. You will verify and organize credentialing and privileging files for providers and staff, perform primary source verifications, and keep credentialing software up to date.

You will collaborate with Compliance, HR, Billing, and CVO, monitor expiring licenses, and ensure timely responses to inquiries while upholding regulatory standards.