Senior Facility Credentialing & Compliance Specialist

HealthFirst; Sioux Falls (SD); On-site; USD 50,000 - 75,000; Full time

Job summary

Healthfirst in Sioux Falls is seeking a Credentialing Specialist to manage provider, facility, and vendor credentialing and re-credentialing, prepare directories, and align data with state and federal regulations. You will support audits, coordinate with third-party vendors, and help maintain accurate records for regulatory compliance.

The role requires a HS diploma/GED with experience in credentialing; a Bachelor’s degree and strong time/project management, critical/creative thinking,

Qualifications

• HS diploma or GED required.
• Facility credentialing experience or exposure preferred.
• Bachelor’s degree and relevant experience are a plus.
• Strong time and project management, critical/creative thinking, communication, and problem-solving skills.
• Proficiency in Microsoft software: Adobe, Access, Excel, Word, PowerPoint, Office.

Responsibilities

• Credential and re-credential providers, facilities, and vendors.
• Prepare hard-copy directories and coordinate with third-party vendors for online postings.
• Review network provider data for accuracy and regulatory compliance.
• Support quarterly credentialing and vendor oversight committee meetings.
• Facilitate audits to ensure adherence to contractual obligations.
• Identify process improvement opportunities and raise issues to management.

Skills

Time management

Project management

Critical thinking

Creative thinking

Communication

Problem-solving

Education

HS diploma/GED

Bachelor's degree

Tools

Adobe

Access

Excel

Word

PowerPoint

Office

Job description

Healthfirst in Sioux Falls is seeking a Credentialing Specialist to manage provider, facility, and vendor credentialing and re-credentialing, prepare directories, and align data with state and federal regulations. You will support audits, coordinate with third-party vendors, and help maintain accurate records for regulatory compliance.

The role requires a HS diploma/GED with experience in credentialing; a Bachelor’s degree and strong time/project management, critical/creative thinking,