CREDENTIALING SPECIALIST Job at Creative Financial Staffing, Pittsburgh, PA

Mnpod0JwSXBEdVhBdy9CZ0I4OEN5VzFyN0E9PQ==
  • Creative Financial Staffing
  • Pittsburgh, PA

Job Description

CREDENTIALING SPECIALIST
Pittsburgh, PA $50,000- $60,000

Are you detail-oriented, organized, and passionate about maintaining high standards in healthcare compliance? We are seeking a Credentialing Specialist to join our client's team and ensure all providers meet the regulatory and organizational standards required to deliver quality care.
  • Be part of a mission-driven team committed to delivering quality care.

  • Opportunities for professional growth and advancement.

  • Competitive benefits, PTO, and work-life balance.

OVERVIEW OF THE CREDENTIALING SPECIALIST ROLE:

  • Manage the full credentialing and re-credentialing process for healthcare providers (physicians, NPs, PAs, etc.).

  • Collect, review, and verify all required documentation, licenses, certifications, and background checks.

  • Submit and track applications to insurance plans, hospitals, and other regulatory bodies.

  • Maintain and update credentialing databases and provider files with current information.

  • Monitor expiration dates and proactively initiate the renewal process for licensure and credentials.

  • Communicate regularly with providers, payers, and internal departments to ensure compliance and timely processing.

  • Assist in audits and ensure compliance with NCQA, CMS, and other regulatory requirements.

PREFERRED QUALIFICATIONS FOR THE CREDENTIALING SPECIALIST:

  • 2+ years of experience in credentialing or provider enrollment within a healthcare setting.

  • Strong understanding of state and federal credentialing guidelines.

  • Proficient in credentialing software (e.g., CAQH, Availity, or similar platforms).

  • High attention to detail and excellent organizational skills.

Job Tags

Full time,

Similar Jobs

Joyce University of Nursing and Health Sciences

Student Success Advisor Job at Joyce University of Nursing and Health Sciences

 ..., however we may consider highly experienced individuals for a remote role. WHATS IN IT FOR YOU: ~ Self-Directed PTO policy...  ...disability ~ Life Insurance ~ Professional Development ~ Education assistance WHAT YOU DO EVERYDAY: Service assigned students... 

Financial Technology Partners

Associate, Investment Banking Job at Financial Technology Partners

 ...the Year" awards by The M&A Advisor.Founded by Steve McLaughlin, our Managing Partner and a former senior investment banker at Goldman Sachs & Co., FT Partners comprises a team of highly experienced professionals with backgrounds in the financial technology, M&A, and investment... 

KPMG US

Senior Associate, Workforce Transformation HCA - UKG (Washington) Job at KPMG US

 ...Senior Associate, Workforce Transformation HCA - UKG Join to apply for the Senior Associate, Workforce Transformation HCA - UKG role at KPMG US Senior Associate, Workforce Transformation HCA - UKG 3 days ago Be among the first 25 applicants Join to apply for the... 

Monticciolo Family and Sedation Dentistry, PA

Dental Assistant Job at Monticciolo Family and Sedation Dentistry, PA

 ...Job Description Job Description Overview: Busy, privately owned dental office, is seeking an energetic and knowledgeable Dental Assistant. Our company features 12 locations with huge opportunity for internal growth. The ideal candidate will have a lot of experience... 

Wayne-Sanderson Farms

Senior Field Recruiter Job at Wayne-Sanderson Farms

 ...Job Description Job Summary PRIMARY FUNCTION: The Senior Field Recruiter oversees the hourly recruiting process from sourcing qualified candidates through the job offer process. This role develops and implements staffing strategies to attract qualified candidates...