Strategic Healthcare Credentialing Specialist

Primary Health Solutions; Hamilton (OH); On-site; USD 60,000 - 85,000; Full time

Job summary

Primary Health Solutions is seeking a Credentialing Specialist to coordinate initial credentialing, recredentialing, and licensure verification for our licensed clinical staff. This role ensures compliance with HRSA, CMS, state boards, and payer requirements while maintaining accurate provider records throughout employment.

The position does not perform payer enrollment, billing, or revenue cycle activities.

Qualifications

• High school diploma or GED minimum; associate degree or higher preferred.
• Minimum of 2 years credentialing experience in healthcare is preferred.
• Experience with credentialing workflows and regulatory standards is a plus.

Responsibilities

• Coordinate initial credentialing and recredentialing for licensed clinical personnel.
• Perform primary source verification for licenses, education, training, residency, and board credentials.
• Maintain credentialing files in compliance with regulatory requirements.
• Monitor expirations for licenses and certifications; notify leadership of upcoming renewals.
• Complete credentialing checklists for providers and staff before board cycles; maintain records.
• Assist with applications and paperwork, gathering signatures; collaborate with HR during orientation.
• Maintain confidentiality of provider and staff information; generate status reports as needed.
• Assist during audits and accreditation reviews; track expirations and renewal statuses.

Skills

Customer Service

Communication

Dependability

Quality

Productivity

Education

High school diploma or GED

Associate degree preferred

Tools

Practice management system

Electronic Medical Record (EMR)

Microsoft Word

Text paging

Internet

Job description

Primary Health Solutions is seeking a Credentialing Specialist to coordinate initial credentialing, recredentialing, and licensure verification for our licensed clinical staff. This role ensures compliance with HRSA, CMS, state boards, and payer requirements while maintaining accurate provider records throughout employment.

The position does not perform payer enrollment, billing, or revenue cycle activities.