Provider Credentialing Specialist — Compliance & Data Integrity

RiseMe; Murray (UT); On-site; USD 52,000 - 64,000; Full time

Job summary

University of Utah Health seeks a credentialing professional to manage monthly credentialing and three-year re-credentialing for medical and allied health staff, ensuring compliance and accurate provider data within the credentialing system.

You will maintain documentation, support audits, and liaise with multiple departments to uphold regulatory standards and data integrity. Strong communication and MS Office skills are essential.

Qualifications

• Bachelor's Degree in a Healthcare or Business Management or equivalency.
• Two years of related experience.
• Certified Provider Credentialing Specialist designation preferred.
• Knowledge of NCQA standards and related regulations.

Responsibilities

• Facilitates monthly credentialing and three year re-credentialing process for medical and allied health professional staff to ensure compliance with bylaws and regulatory requirements.
• Implements process improvements to increase efficiency while ensuring compliance with bylaws and regulatory requirements.
• Participates in annual audits of the credentialing program.
• Maintains all credentialing documentation and provider updates to ensure reliable, efficient retrieval of information by staff.
• Analyzes data between provider database and Epic and reporting discrepancies.
• Maintains data integrity in provider database regarding credentialing information.
• Assists with completion of special projects as requested by various internal departments or in support of requests from regulatory agencies, contracting agencies or other internal/external organizations.
• Exhibits excellent customer relations with office visitors, department coordinators, committee members, coworkers and outside contacts.

Skills

Credentialing knowledge

Communication skills

Confidentiality

Detail oriented

Microsoft Office

Data integrity

Relationship management

Research skills

Education

Bachelor's degree in Healthcare or Business Management

Equivalency accepted

Tools

Microsoft Access

Excel

Word

Job description

University of Utah Health seeks a credentialing professional to manage monthly credentialing and three-year re-credentialing for medical and allied health staff, ensuring compliance and accurate provider data within the credentialing system.

You will maintain documentation, support audits, and liaise with multiple departments to uphold regulatory standards and data integrity. Strong communication and MS Office skills are essential.