Impactful Credentialing & Compliance Specialist

Paradigm; Tampa (FL); On-site; USD 42,000 - 64,000; Full time

Job summary

Paradigm, located in Tampa, FL, is seeking a detail-oriented Credentialing Specialist to support credentialing and re-credentialing of healthcare providers. The role emphasizes accuracy, compliance, and collaboration with QAIR, Risk Management, and Provider Relations teams.

You will maintain practitioner files, verify licenses and certifications, and ensure data integrity within credentialing systems, while upholding confidentiality and security policies consistent with the organization.

Qualifications

• Bachelor's degree in healthcare or technical field preferred.
• Exceptional communication and telephone skills required.
• Experience working with physicians and/or senior executives preferred.
• Strong organizational and multitasking abilities; ability to work independently.
• Proficient computer skills; familiarity with Microsoft Office.
• Knowledge of medical terminology preferred.
• NAMSS CPCS or CMSC preferred.

Responsibilities

• Completes credentialing and re-credentialing application process for internal and affiliated practitioners.
• Processes requests, investigations, verifications, tracking and follow-up from sources.
• Identifies, investigates, reports, and follows up on adverse information from credentialing sources.
• Maintains knowledge of policies, standards, regulations, and laws in credentialing.
• Populates and maintains credentialing software and filing systems.
• Assists with reports and RFPs in collaboration with supervisor.

Skills

Exceptional communication

Telephone skills

Organizational skills

Multitasking

Self-directed work

Education

Bachelor's degree in healthcare or technical field

Tools

Microsoft Office

Job description

Paradigm, located in Tampa, FL, is seeking a detail-oriented Credentialing Specialist to support credentialing and re-credentialing of healthcare providers. The role emphasizes accuracy, compliance, and collaboration with QAIR, Risk Management, and Provider Relations teams.

You will maintain practitioner files, verify licenses and certifications, and ensure data integrity within credentialing systems, while upholding confidentiality and security policies consistent with the organization.