Facility Credentialing Specialist

Curana Health, Inc.; USA; Remote; USD 65.000 - 95.000; Vollzeit

Zusammenfassung

Curana Health, Inc. is seeking a Credentialing Specialist for Facilities to ensure our provider network meets regulatory standards and supports safe, compliant care across our national footprint.

You will review facility credentialing applications, coordinate verifications, manage data in credentialing systems, and monitor expirations while collaborating with contracting and compliance teams to keep our network robust and up to date.

Qualifikationen

• High school diploma required; healthcare credentialing experience a plus.
• Experience in credentialing or related field preferred, but not required.
• Proficient in Excel and Word; familiarity with credentialing databases a plus.
• Strong attention to detail and ability to maintain confidentiality.
• Flexible, team-oriented, and able to work with minimal supervision.
• Strong verbal and written communication skills.

Aufgaben

• Credentialing review and evaluation of facility applications for accuracy and compliance.
• Engage with facilities to clarify credentialing questions and obtain missing information.
• Update credentialing software and manage facility data; perform corrections.
• Manage recredentialing applications and timely processing per guidelines.
• Monitor facility licenses, DEA certificates, and document expiration dates.
• Prepare reports for Credentialing Committee and issue notices as needed.
• Assist contracting with credentialing support and status updates.

Kenntnisse

Excel

Word

Confidentiality

Attention to detail

Teamwork

Communication

Ausbildung

High school diploma

Tools

Credentialing databases

Jobbeschreibung

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults—and we're looking for passionate people to help us do it.

As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide range of solutions (including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans) proven to enhance health outcomes, streamline operations, and create new financial opportunities.

Founded in 2021, we've grown quickly—now serving 200,000+ seniors in 1,500+ communities across 32 states. Our team includes more than 1,000 clinicians alongside care coordinators, analysts, operators, and professionals from all backgrounds, all working together to deliver high-quality, proactive solutions for senior living operators and those they care for.

Ranked #147 on the Inc. 5000 list of America's fastest-growing private companies, we're just getting started. If you're looking to make a meaningful impact on the senior healthcare landscape, you're in the right place—and we look forward to working with you.

For more information about our company, visit CuranaHealth.com.

Summary

The Credentialing Specialist for Facilities ensures that the health plan’s provider network includes facilities that meet regulatory standards. This position plays a crucial role in ensuring compliance, safeguarding member safety, and minimizing liability for the company.

Essential Duties & Responsibilities

Credentialing Review & Evaluation: Evaluate facility credentialing applications for accuracy and completeness based on specialty requirements. Obtain the necessary verifications and ensure compliance with regulatory standards.

Communication: Engage with facilities to clarify credentialing-related questions and obtain missing information to complete their application.

Data Entry & Management: Update and maintain credentialing software systems with necessary facility information. Perform data corrections and ensure all files are complete and up to date.

Recredentialing & Follow-Up: Request and follow up on recredentialing applications, ensuring timely processing and compliance with internal guidelines.

Monitoring & Compliance: Regularly monitor facilities' expiration dates for licenses, DEA certificates, and other relevant documentation. Present summary reports to the Credentialing Committee monthly.

Sanctions & Exclusions Review: Review federal and state sanctions/exclusions reports to ensure facilities comply with regulations.

Reporting & Documentation: Generate and distribute credentialing reports to internal teams. Prepare and send formal notices of approval, requests for additional information, and termination notices as required by the Credentialing Committee.

Support & Collaboration: Assist the contracting department with credentialing support and provide ongoing status updates on facilities' credentialing status.

Qualifications

Education: High school diploma required; additional certification or experience in healthcare credentialing is a plus.

Experience: Prior experience in credentialing or related field preferred, but not required.

Skills:

• Proficient in Microsoft Excel and Word; familiarity with credentialing databases is a plus.
• Strong attention to detail and ability to maintain confidentiality.
• Flexible, team-oriented, and capable of working with minimal supervision.
• Strong verbal and written communication skills.