Credentialing Specialist @CHG Medical Staffing, Inc.

[Hiring] Credentialing Specialist @CHG Medical Staffing, Inc.

Mar 26, 2025 - CHG Medical Staffing, Inc. is hiring a remote Credentialing Specialist. 💸 Salary: $36,795 -- $89,192 annually. 📍Location: USA.

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Role Description

The Credentialing Specialist is responsible for credentialing and recredentialing client practitioners as well as ensuring enrollment with participating client health plans. Credentialing functions include, but are not limited to:

Processing credentialing applications
Performing primary source verifications
Updating and maintaining credentialing database in accordance with internal policies and procedures, client health plan contracts, and applicable state and federal requirements

Responsibilities include:

Initiate and support the practitioner application process by sending, receiving, and analyzing practitioner documents and data import to determine completeness in preparation for payor enrollment and credentials verification process
Responsible for accurate data entry to ensure the integrity of credentialing information in applicable database(s)
Enroll providers with client payors to include Medicare, Medicaid, and state and federal commercial health plans and follow up as required until process complete
Update CAQH and NPI information consistent with client practice information
Gather, verify, and evaluate highly confidential and sensitive health care practitioner credentials consistent with departmental guidelines and accreditation standards
Respond to all practitioner, client health plan, and internal inquiries in a timely manner
Monitor expiring licensure, board and professional certifications, and other expirable documents with practitioners within the prescribed timeframe
Maintain practitioner paper and electronic data files for clients; utilizing CAQH to submit practitioner data as required to credential individual practitioners
Collaborate with participating clients in a professional manner, department manager, and/or external agencies to facilitate and ensure smooth hand-off during the credentialing process
Follow up with individual practitioners and internal and external entities to resolve discrepancies identified during the credentialing process
Perform all aspects of credentialing verification, including initial credentialing and recredentialing to ensure current credentials and timely handoff and/or review and approval of practitioner files
Conduct sanctions and compliance monitoring and alert Manager of any undisclosed negative findings immediately
Participate in team meetings and process improvement initiatives to continuously improve work product quality and efficiency
Contribute to a positive culture
Keep Manager informed of potential credentialing or enrollment issues

Qualifications

Familiarity using payor websites including but not limited to CAQH, Pecos, NPI/NPPES, Availity, Navinet, CMS I&A
Familiar with payor enrollment process for all levels of licensure including but not limited to MD/DO, NP, PhD, PT, OT, LCSW, OD, DDS, DPM, etc. across all specialties including medical, dental, vision, behavioral health, and physical health
Experience should include responsibility for medical and professional credentialing processes, policies and procedures, and delegated credentialing requirements
Able to communicate clearly and concisely, both verbally and in written correspondence
Able to work well under tight deadlines and respond to rapidly changing demands and provide efficient follow up
Detail oriented with ability to recognize vital information from credentialing documents
Demonstrate problem-solving, critical thinking, and deductive reasoning skills
Ability to consistently maintain quality and production expectations
Ability to learn and use credentialing database and other related databases
Capable and comfortable dealing with sensitive and confidential information with discretion and trust
Proficiency with MS Office suite

Requirements

Associate’s degree; or, an equivalent combination of education and/or experience
Minimum of 3 years’ experience in provider credentialing in a healthcare setting
Preferred Certified Provider Credentialing Specialist (CPCS)

Benefits

401(k) retirement plan with company match
Traditional healthcare benefits such as medical and dental coverage, and some unique benefits like onsite health centers, corporate wellness programs, and free behavioral health appointments
Flexible work schedules - including work-from-home options available
Recognition programs with rewards including trips, cash, and paid time off
Family-friendly benefits including paid parental leave, fertility coverage, adoption assistance, and marriage counseling
Tailored training resources including free LinkedIn learning courses
Volunteer time off and employee-driven matching grants
Tuition reimbursement programs

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📍	Be aware of the location restriction for this remote position: USA
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Credentialing Specialist @CHG Medical Staffing, Inc.

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Salary 💸 $36,795 -- $89,192 annually	Remote Location USA
Job Type full-time	Posted Mar 26, 2025

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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