Senior Credentialing Specialist

HCA Healthcare; Las Vegas (NV); On-site; USD 45,000 - 68,000; Full time

Job summary

HCA Healthcare is seeking a Credentialing Processing Center Specialist II to safeguard patient wellbeing by ensuring accredited practitioners have verified credentials across hospitals and facilities.

You will collaborate with 350+ internal customers and external partners, manage documentation, uphold Joint Commission standards, and drive timely credentialing decisions to support safe patient care.

Qualifications

• Associate’s degree or equivalent work experience.
• Bachelor’s degree preferred.
• 5+ years’ experience in healthcare credentialling with Parallon or HCA required.
• Experience with Credentialing Accreditation by Joint Commission or National Committee for Quality Assurance, preferred.
• NAMSS Certification preferred.
• Remote employees are required to live within 60 miles of an HCA hospital.
• Remote employees are required to have wired internet with 25 Mbps download and 15 Mbps upload.
• Detailed working knowledge of healthcare credentialing and regulatory issues.

Responsibilities

• Mastery communication and regulatory guidelines, policies, procedures, and internal systems, coupled with keen insight into practitioner 350+ internal customers, plus external customers.
• Forges collaborative partnerships with over 350+ healthcare facilities, customers, and stakeholders.
• Mastered competency and extensive experience through review of Data Integrity Reviews, Specialist Reviews, and Compliance Reviews, that supports precise accurate identification of potential practitioner issues and flagging of practitioner risk.
• Adheres to stringent regulatory guidelines, Joint Commission Standards, Facility Bylaws and CPC standards.
• Ensures the flawless, timely, and accurate credentialing of medical and allied healthcare providers, upholding the highest standards of quality.
• Mastered through experience the competency to discern and escalate practitioner risk concerns by utilizing policies and verification elements.
• Orchestrates comprehensive collection of information and manages follow-up for missing documentation with practitioners and external organizations.
• Identifies and analyzes potential compliance flags and collaborates with practitioners on sensitive issues with external organizations.
• Mastered the ability to document resolution and unresolved complex issues and escalations in practitioner files for potential future reviews.
• Provides strategic counsel to Managers and Directors regarding ambiguous information and escalates critical issues identified during credentialing.

Skills

Regulatory guidelines

Credentialing processes

Communication with internal/external

Data integrity reviews

Compliance awareness

Relationship building

Education

Associate’s degree or equivalent

Bachelor’s degree preferred

Tools

Joint Commission standards

Job description

HCA Healthcare is seeking a Credentialing Processing Center Specialist II to safeguard patient wellbeing by ensuring accredited practitioners have verified credentials across hospitals and facilities.

You will collaborate with 350+ internal customers and external partners, manage documentation, uphold Joint Commission standards, and drive timely credentialing decisions to support safe patient care.