Credentialing Specialist

Job Description

JOB SUMMARY

The Credential Specialist position is responsible for ensuring that the candidates are fully compliant with all state and federal regulations. They must also ensure that every staff member is legally licensed and/or credentialed and up to date with the latest medical policies and procedures.

DUTIES AND RESPONSIBILITIES

Create and maintain licensing, credentials, and insurance records.

Conduct research on updated state and federal regulations and policies.

Release information to requesting agencies and public inquiries when required by law.

Help develop internal credentialing processes.

Monitor license and credential expiration dates and advise staff members of required “renew by” dates.

Ensure the facility and staff members are maintaining compliance with regulatory and accrediting institutions.

Research, analyze, and evaluate credentialing applications, ensuring all relevant information has been submitted; distribute and receive the application.

Ensure credentialing applications are tracked and monitored for adherence to timelines.

Enter demographic and credentialing information into credentialing software in a timely and accurate manner.

Monitor and document credentialing efforts.

Create and construct files; prepare files for review.

Assemble relevant data and prepare scheduled and ad-hoc reports as needed.

Ensure re-credentialing of providers according to policies and procedures.

EXPERIENCE

2+ years of experience in credentialing or Provider enrollment.

Proficient in using credentialing software and databases for data entry and maintenance.

Excellent writing, editing, and oral communication skills.

Strong analytical and problem-solving skills.

Exceptional organizational and time management abilities.

Effective communication and interpersonal skills.

Ability to work independently and collaboratively within a team.

EDUCATION

High School Diploma Required, Associate or Bachelor s degree preferred.

SKILLS & ABILITIES

Minimum of 2 (two) years Human Resources experience in recruitment, onboarding, employment compliance preferred within a Staffing Agency Environment

Strong computer skills and proficiency in MS Word, Excel, and Outlook required; intermediate computer skills and experience with applicant tracking systems preferred.

Highly organized with a strong attention to detail.

Must have ability to travel two to three times per year to assist with onsite visits.

Must have a valid driver s license.

PHYSICAL REQUIREMENTS

The physical demands described here represent those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions. Prolonged periods of sitting at a desk and working on a computer. Occasional standing and walking. Frequent use of hands and fingers. Frequent periods of talking and listening. Occasional reaching, bending, pulling, and lifting up to 15 lbs.

The Maasai Group is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.