Credentialing Specialist
Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.
*This position is located Remote United States*
Position Purpose
Responsible for managing and assisting the Independent Review Organization (IRO) team with aspects of the credentialing and re-credentialing processes for medical providers and other healthcare professionals, ensuring compliance with state, federal, and organizational regulations. Responsible for managing the company’s Quality Management System (QMS) documents, adhering to International Organization for Standardization (ISO) and Utilization Review Accreditation Commission (URAC) requirements.
Essential Responsibilities
- Processes re-credentialing for physicians, advanced practitioners, and other healthcare professionals.
- Verifies and validates provider qualifications, licensure, education, training, board certification, work history, and malpractice history.
- Maintains accurate and up-to-date credentialing records in credentialing databases and systems (e.g., LawBase).
- Monitors expiring credentials and facilitate timely renewals.
- Prepares reports and audits as needed for credentialing status and compliance tracking.
Minimum Qualifications
Education
- High School Diploma or equivalent
License, Certification, or Training
- Certified Provider Credentialing Specialist (CPCS) or certified ISO auditor, preferred
Experience
- One (1) year experience in credentialing
- Document management
- ISO and/or URAC, preferred
- LawBase, preferred
Benefits
C2C offers an excellent benefits package, including:
- Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
- Section 125 plan
- 401K
- Competitive salary
- License/credentials reimbursement
- Tuition Reimbursement
EOE Vet/Disability
Apply To This Job