Remote Credentialing Specialist – Healthcare

Dunhill Professional Search & Government Solutions; United States; Remote; USD 55,000 - 75,000; Full time

Job summary

Dunhill Government Solutions is hiring a Credentialing Specialist to process credentialing and re-credentialing applications for healthcare practitioners supporting a federal military health program. You will verify credentials at the primary source and maintain CCQAS records while coordinating with treatment facilities and licensing agencies.

This is a full-time telework role. Responsibilities include PSV verifications, data loading, problem resolution, and ensuring regulatory compliance.

Qualifications

• High school diploma or GED.
• 2–5 years of physician credentialing experience in a medical group, hospital or health plan.
• Strong customer focus and interpersonal skills, plus written/verbal communication and computer skills.
• Excellent attention to detail and ability to manage multiple tasks.
• Ability to handle confidential information professionally.

Responsibilities

• Process credentialing and re-credentialing applications; review applications and prepare verification letters.
• Contact departments, licensing agencies and insurance carriers to complete credentialing and re-credentialing applications.
• Conduct Primary Source Verification (PSV) of licenses, certifications, registrations and education.
• Run queries through NPDB, DPDB, and DHHS/TRICARE sanction data banks.
• Load data into CCQAS and maintain up-to-date records.
• Research and resolve credentialing problems and escalate complex issues.
• Track credential status and provide documents for accession and privileging decisions.
• Maintain relationships with Military Treatment Facilities and supported customers.
• Ensure providers are credentialed, appointed and privileged with health plans and facilities.
• Review records for regulatory compliance and quality assurance.

Skills

Customer focus

Interpersonal skills

Collaboration

Written/verbal communication

Prioritization

Computer skills

Education

High school diploma or GED

Job description

Dunhill Government Solutions is hiring a Credentialing Specialist to process credentialing and re-credentialing applications for healthcare practitioners supporting a federal military health program. You will verify credentials at the primary source and maintain CCQAS records while coordinating with treatment facilities and licensing agencies.

This is a full-time telework role. Responsibilities include PSV verifications, data loading, problem resolution, and ensuring regulatory compliance.