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Credentialing Specialist
Stone Harbor Staffing Group. Perform initial credentialing, recredentialing, and/or privileging for providers and clinical teams throughout the US.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in credentialing processes, including initial credentialing, recredentialing, and privileging for healthcare providers. Proficient in managing compliance documents and communicating effectively with various stakeholders while ensuring adherence to laws and regulations.
Highest-signal resume keywords
Credentialing ExperienceCertified Provider Credentialing Specialist (CPCS)Compliance ManagementData VerificationEffective Communication
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
CredentialingData VerificationCompliance ManagementApplication ReviewReport Monitoring
Soft Skills
Decision MakingAnalytical ThinkingGoal SettingEffective Dialogue
Tools & Technologies
Credentialing Database
Certifications & Qualifications
Certified Provider Credentialing Specialist (CPCS)
Industry Keywords
Healthcare StaffingProvider InformationRegulatory ComplianceBusiness StrategyPolicy Adherence
About the role
Key responsibilities & impact- Perform initial credentialing, recredentialing, and/or privileging for providers and clinical teams throughout the US.
- Collect and verify sensitive provider and clinician data through confidential sources.
- Manage, upload, and maintain compliance documents in required systems.
- Review reports to monitor application completion.
- Assess and interpret application and verification information to identify red flags or non-compliance.
- Communicate adverse, incomplete, or questionable data and recommend appropriate action.
- Manage communications between multiple parties while meeting policy timelines.
- Update the credentialing database and provide status reports.
- Communicate provider and clinician participation information to internal and external customers.
- Communicate with federal, state, and local agencies, hospitals, medical review boards, educator review boards, and malpractice carriers to obtain provider information.
Requirements
What you’ll need- One year of experience in education or healthcare staffing credentialing.
- Certified Provider Credentialing Specialist (CPCS) can substitute for experience.
- Overall knowledge of business functions and understanding of services, business strategy, policies and procedures, and the job’s impact to the organization.
- Ability to obtain facts and data pertaining to an issue or question.
- Ability to make quality decisions and meet timeliness of those decisions.
- Understanding, interpretation, and compliance with laws and regulations.
- Maintain trust through honesty, adherence to principles, and personal accountability.
- Ability to analyze work, set goals, develop plans of action, and utilize time.
- Ability to engage effectively in dialogue.
Benefits
Comp & perks- Competitive salary package, including performance bonuses.
- HMO (medical and dental) & Life Insurance coverage.
- Paid vacation and sick leave credits.
- Extra allowances for WFH set-up such as internet subsidy and transportation allowance for WFO set-up.
- Medicine & Optical reimbursements.
- Career development and advancement opportunities.