Credentialing Specialist

Credentialing Assistant – Job Description 

Position Summary 
The Credentialing Assistant supports the credentialing department by collecting, verifying, and maintaining provider information to ensure compliance with organizational, state, and regulatory standards. This role helps facilitate timely onboarding and re-credentialing of healthcare providers and contributes to maintaining accurate and up-to-date credentialing records 

Key Responsibilities 

Assist in the processing of initial credentialing, re-credentialing, and privileging applications for healthcare providers. 

Collect, review, and verify provider documentation (licenses, certifications, education, training, work history, background checks, malpractice insurance, etc.). 

Enter and maintain accurate provider data in credentialing databases and tracking systems. 

Communicate with providers, internal staff, regulatory agencies, and external organizations to obtain required information and resolve discrepancies. 

Monitor expiring credentials and send timely reminders to providers. 

Prepare and organize files for credentialing committee meetings and compliance audits. 

Maintain confidentiality of sensitive provider information in accordance with HIPAA and organizational policies. 

Support the Credentialing Specialist or Credentialing Manager with administrative tasks as needed. 

Willing to travel to other clinics 

Other tasks as needed 

Qualifications 

High school diploma required 

Previous experience in healthcare credentialing, or medical office support is a plus. 

Strong attention to detail and ability to manage multiple tasks with deadlines. 

Excellent communication, customer service, and organizational skills. 

Proficiency with Microsoft Office and credentialing or database software. 

Ability to interpret and apply credentialing policies, procedures, and regulatory requirements. 

Skills & Competencies 

Data entry accuracy and document management 

Problem-solving and follow-through 

Professional communication (written and verbal) 

Knowledge of medical terminology (preferred) 

Ability to work independently and collaboratively