Credentialing Specialist

Job Title: Credentialing Specialist Department: Clinic Position type: Full Time 37.5 Hours FLSA: Non-Exempt Job Summary: The Credentialing Specialist ensures timely and accurate credentialing and privileging of clinical staff while maintaining compliance with FQHC, FTCA, and Article 28 standards.

This role supports payer enrollment readiness and manages credentialing databases to ensure operational efficiency and regulatory compliance.

Duties/Responsibilities: * Coordinate initial credentialing, recredentialing, and privileging for licensed and non-licensed clinical staff.

* Ensure compliance with FQHC, FTCA, and Article 28 standards, including primary source verification and recredentialing cycles.

* Maintain accurate credentialing files in CredentialStream (Verity), including licenses, certifications, and sanction checks.

* Support payer enrollment by organizing documentation and collaborating with internal departments to prevent billing delays.

* Monitor expiration dates and notify staff of upcoming renewals.

* Prepare reports for audits, surveys, and FTCA re-deeming applications.

* Collaborate with People Operations to support onboarding and maintain readiness for HRSA site visits.

Required Skills/Abilities: * Strong understanding of credentialing and privileging standards (e.g., Joint Commission). * Familiarity with FQHC, FTCA, Article 28, and HRSA compliance.

* Experience with credentialing software (CredentialStream or similar). * Highly organized and detail-oriented with the ability to manage multiple deadlines.

* Strong written and verbal communication skills.

* Proficiency in Microsoft Office Suite (Word, Excel, Outlook). * NAMSS certification (e.g., CPCS) is preferred.

Education and Experience: * Minimum of 5 years' experience in medical staff credentialing, preferably in a healthcare or FQHC setting.

* High school diploma or GED required; Associate degree or higher preferred.

Physical Requirements: While performing the duties of this job the employee is required to stand, sit, walk, use hands to finger, handle, or feel; reach with hands and arms, talk and hear.

Occasionally the employee must stoop, bend and lift or move up to 25 lbs.

Specific vision abilities required include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.

In support of the Americans with Disabilities Act, this job description highlights only those responsibilities and qualifications considered essential for the position.

Equal Employment Opportunity: Trillium Health promotes Equal Employment Opportunity for all, respecting diverse backgrounds, cultures, races, ages, experiences, and opinions.

Employees must meet department performance standards and participate in compliance audits, process improvement, and quality improvement plans.