Credentialing Specialist

Curana Health

. Perform data entry, data collection, and verification of practitioner credentials from primary sources .

Posted 10/27/2026full-timeRemote • United StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in data entry, credentialing processes, and compliance with healthcare standards. Proficient in maintaining data integrity and confidentiality while effectively communicating with healthcare practitioners and internal stakeholders.

Highest-signal resume keywords

Credentialing ExperienceData EntryPrimary Source VerificationCertified Provider Credentialing Specialist (CPCS)Knowledge of Joint Commission Standards

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data CollectionData VerificationApplication ReviewDiscrepancy InvestigationDatabase MaintenanceMonitoring Provider ExpirablesFederal/State Sanctions ReviewNPDB Continuous Query ReviewDelegation Oversight AuditProduction Goal Achievement

Soft Skills

CommunicationCollaborationAttention to DetailProblem-Solving

Tools & Technologies

Credentialing Software

Certifications & Qualifications

Certified Provider Credentialing Specialist (CPCS)

Industry Keywords

HealthcareHospital CredentialingInsurance Plan CredentialingNCQAURACHFAPJoint Commission

About the role

Key responsibilities & impact

Perform data entry, data collection, and verification of practitioner credentials from primary sources
Analyze collected information according to Curana Health policies and procedures
Maintain confidentiality of practitioner information, legal matters, privacy issues, information technology, and data integrity
Review practitioner applications for completeness
Conduct, maintain, and analyze Primary Source Verifications while meeting production goals
Investigate and validate discrepancies and adverse information
Communicate with healthcare practitioners to clarify questions and request missing information
Follow up on application requests and outstanding Primary Source Verifications
Maintain the credentialing software database with complete and accurate data
Communicate with internal and external customers to obtain or provide necessary information
Compile, evaluate, and present practitioner-specific data for Credentials Committee review
Create and send approval, information request, and termination notices based on Credentials Committee decisions
Request recredentialing applications from practitioners and organizational providers
Collaborate with internal and external contacts to process or terminate recredentialing applicants timely
Monitor provider expirables including licenses, DEA, and malpractice insurance
Review federal/state and license sanctions and exclusions reports
Review NPDB Continuous Query reports and take appropriate action
Assist with Delegation Oversight audit reviews, tracking, and reporting

Requirements

What you’ll need

High school diploma required; Associate degree preferred
1-4 years of hospital or insurance plan credentialing experience
Working knowledge of Joint Commission, NCQA, URAC, HFAP standards
Certified Provider Credentialing Specialist (CPCS) preferred
Must be able to work in the US; the company is unable to provide visa sponsorship (H1B or otherwise)