Delegated Credentialing Specialist

CHG Healthcare

. Initiate and support practitioner application processes by sending, receiving, analyzing, and importing practitioner documents and data .

Posted 10/9/2026full-timeRemote • Utah • United StatesMid-LevelSenior💰 $25 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical credentialing processes, including provider enrollment and primary source verification, while maintaining compliance with accreditation standards. Proficient in using credentialing databases and payor websites to ensure accurate data management and timely processing.

Highest-signal resume keywords

Medical Credentialing ProcessesProvider EnrollmentPrimary Source VerificationCAQH ProficiencyCertified Provider Credentialing Specialist (CPCS)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data EntryCredential VerificationCredentialing Database ManagementPayor Enrollment ProcessesCompliance MonitoringAccreditation Standards KnowledgeMS Office ProficiencyProblem-Solving SkillsCritical ThinkingDetail-Oriented

Soft Skills

Clear CommunicationAbility to Work Under Tight DeadlinesAdaptability to Changing Demands

Tools & Technologies

CAQHPecosNPI/NPPESAvailityNaviNetCMS I&A

Certifications & Qualifications

Certified Provider Credentialing Specialist (CPCS)Provider Enrollment Specialist Certificate (PESC)

Industry Keywords

Healthcare CredentialingLicensure MonitoringConfidential Information HandlingAccreditation RequirementsDelegated Credentialing

About the role

Key responsibilities & impact

Initiate and support practitioner application processes by sending, receiving, analyzing, and importing practitioner documents and data
Perform accurate data entry and maintain credentialing database integrity
Enroll providers with Medicare, Medicaid, and state and federal commercial health plans
Update CAQH and NPI information consistent with client practice information
Gather, verify, and evaluate confidential practitioner credentials according to departmental guidelines and accreditation standards
Respond to practitioner, client health plan, and internal inquiries
Monitor expiring licensure, board and professional certifications, and other expirable documents
Maintain practitioner paper and electronic data files and submit practitioner data through CAQH
Collaborate with clients, department manager, and external agencies to facilitate credentialing handoffs
Resolve credentialing discrepancies with practitioners and internal and external entities
Perform initial credentialing and recredentialing verification and ensure timely file handoff or review and approval
Conduct sanctions and compliance monitoring and immediately alert the Manager to negative findings
Participate in team meetings and process improvement initiatives
Keep the Manager informed of credentialing or enrollment issues
Contribute to a positive culture

Requirements

What you’ll need

Proficient using payor websites including CAQH, Pecos, NPI/NPPES, Availity, NaviNet, CMS I&A
Proficiency using software for provider applications, credential verification, and tracking verification statuses
Proficient with payor enrollment processes for MD/DO, NP, PhD, PT, OT, LCSW, OD, DDS, DPM and other licensure levels across medical, dental, vision, behavioral health and physical health specialties
Knowledge of primary source verification and relevant regulations, accreditation requirements, and compliance standards
3-5 years of responsibility for medical credentialing processes, policies, procedures, and delegated credentialing requirements
Minimum of 3 years’ experience in provider credentialing in a healthcare setting
Clear and concise verbal and written communication
Ability to work under tight deadlines and respond to changing demands
Detail-oriented with ability to identify vital information in credentialing documents
Problem-solving, critical thinking, and deductive reasoning skills
Ability to maintain quality and production expectations
Ability to learn and use credentialing and related databases
Ability to handle sensitive and confidential information with discretion and trust
Proficiency with MS Office suite
Associate’s degree; or, an equivalent combination of education and/or experience
Certified Provider Credentialing Specialist (CPCS) preferred
Provider Enrollment Specialist Certificate (PESC) preferred

Benefits

Comp & perks

Flexible work schedules - including work from home options available
Award-winning training and development programs
Competitive pay