Job Description

Position Overview:

We are seeking a detail-oriented Credentialing Specialist to support the verification and processing of provider credentials. The ideal candidate will ensure regulatory compliance by maintaining accurate and timely documentation related to provider licensure, education, training, and certifications. This role plays a critical part in upholding quality assurance standards and legal requirements related to medical staff credentialing.

Key Responsibilities:

• Enforce regulatory and organizational compliance standards in the credentialing process.
• Process applications for initial appointments and reappointments (approximately 125–200 quarterly).
• Verify provider credentials, education, training, licensure, and professional references.
• Maintain and update provider data in the credentialing database (e.g., Echo or equivalent).
• Prepare reports and materials for credentialing meetings and review committees.
• Track and monitor license and certification expirations to avoid lapses.
• Collect and process provider documentation and dues as needed.
• Maintain the confidentiality of provider information and credentialing records.
• Ensure credentialing practices align with applicable Bylaws and regulatory standards.
• Attend and document meetings related to medical staff credentialing when required.
• Perform other credentialing-related duties as assigned.

Required Qualifications:

• Knowledge of medical staff credentialing processes is required.
• Strong organizational and time management skills with the ability to handle multiple priorities.
• Excellent communication skills (both verbal and written).
• Ability to analyze and validate provider data effectively.
• Comfortable working independently with minimal supervision.
• High level of accuracy and attention to detail.
• Proficiency in credentialing software and Microsoft Office applications.

Additional Notes:

• This role does not involve insurance credentialing.
• The Credentialing Specialist will help ensure all medical staff credentials are up to date and in compliance with local, state, and federal regulations.

Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors

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