Remote Credentialing and Privileging Specialist

Kids for the Future; Augusta (GA); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Competitive salary

Employer-paid insurance

401k with employer match

Dental & Vision insurance

Paid time off

Job summary

Christ Community Health Services Augusta is seeking a Credentialing and Privileging Specialist to ensure clinical staff maintain licenses, certifications and privileges in compliance with HRSA and FQHC standards. You will manage credentialing and renewals, maintain documentation, and verify qualifications for new and existing staff.

The role reports to the Credentialing & Privileging Manager in Administration and Management, with responsibilities across CMS regulations, CAQH, payer portals, and

Qualifications

• At least three years of experience as professional support in health care, preferably in the medical staff services field (Required).
• Two years of experience in credentialing, privileging, enrollment or similar healthcare professional verification and organization’s accreditation processes (Preferred).
• Certified Provider Credentialing Specialist (CPCS), Certified Professional Medical Services Management (CPMSM) or Certified Provider Enrollment Specialist (CPES) (Preferred).
• Proficiency in using CredentialStream (VerityStream) (Preferred).
• Knowledgeable in CMS regulations and state boards.

Responsibilities

• Maintains compliance with regulatory and accrediting institutions with HRSA requirements for FQHCs.
• Monitors staff credentials and privileges and works with management to ensure continuous compliance.
• Develops, maintains, and utilizes tools to ensure compliance including electronic platforms.
• Supports and works with the insurance credentialing team to ensure efficient credentialing.
• Assists with Risk Management projects as needed.

Skills

CMS regulations

CAQH & payer portals

Credentialing workflows

Adobe / FoxIt PDF

MS Office

Attention to detail

Time management

Communication skills

Teamwork

Education

Three years healthcare staff support experience

Credentialing experience (2 yrs)

CPCS/CPMSM/CPES preferred

CredentialStream (VerityStream) proficiency

Tools

CredentialStream (VerityStream)

Microsoft Office

Adobe / FoxIt PDF

Job description

Christ Community Health Services Augusta is seeking a Credentialing and Privileging Specialist to ensure clinical staff maintain licenses, certifications and privileges in compliance with HRSA and FQHC standards. You will manage credentialing and renewals, maintain documentation, and verify qualifications for new and existing staff.

The role reports to the Credentialing & Privileging Manager in Administration and Management, with responsibilities across CMS regulations, CAQH, payer portals, and