Provider Credentialing & Compliance Specialist

Salt-River-Pima--maricopa-Indian-Community-; Scottsdale (AZ); On-site; USD 52,000 - 75,000; Full time

Job summary

Salt River Pima-Maricopa Indian Community Health and Human Services seeks a Credentialing Specialist to manage credentialing, privileging and re-credentialing for physicians, NPs, PAs and behavioral health providers, ensuring enrollment with payers and compliance with licensing boards.

Under supervision of the Quality and Compliance Administrator, you’ll maintain provider files, verify licenses, support audits, and collaborate with HR, billing and clinical leadership to ensure timely

Qualifications

• Associate degree and 1 year credentialing experience required.
• Bachelor’s degree preferred.
• CPCS certification preferred within 1 year of eligibility.

Responsibilities

• Manage initial credentialing and recredentialing for providers.
• Verify licenses, certifications, DEA registrations, and board credentials.
• Ensure regulatory compliance and maintain audit-ready files.
• Track expirations and manage re-credentialing monitoring.
• Assist with payer enrollment and contracting updates.
• Maintain complete provider credentialing files with supporting docs.
• Collaborate with HR, Billing and clinical leadership.
• Support quality improvement and risk management initiatives.
• Handle miscellaneous duties to improve operations.

Skills

Credentialing

Privileging

HIPAA compliance

Data analysis

Communication

Time management

Documentation

Independent work

Education

Associate’s degree

Bachelor’s degree preferred

CPCS certification preferred

Tools

MS Office

EHR systems

Data entry

Job description

Salt River Pima-Maricopa Indian Community Health and Human Services seeks a Credentialing Specialist to manage credentialing, privileging and re-credentialing for physicians, NPs, PAs and behavioral health providers, ensuring enrollment with payers and compliance with licensing boards.

Under supervision of the Quality and Compliance Administrator, you’ll maintain provider files, verify licenses, support audits, and collaborate with HR, billing and clinical leadership to ensure timely