Credentialing Specialist

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Job Description - Credentialing Specialist

Description & Requirements Maximus is currently hiring for a Credentialing Specialist to join our Veterans Evaluation Services (VES) team. This is a remote opportunity. The Credentialing Specialist is responsible for the input, management, categorization, screening, and processing of all credentialing paperwork and information related to each healthcare provider who is recruited by the VES Provider Recruiters to ensure compliance with contractual credentialing requirements. Essential Duties and Responsibilities: - Compiles and creates the credentialing and training paperwork that each prospective VES provider is required is complete per VES' contract with the VA. - Distributes Credentialing Packets as requested by the Recruiter, including HIPAA and DEMO/MST packets. - Assist the Provider Recruiters in sending paperwork and training materials to the providers. - Compiles, researches, and screens all Providers via NPDB, IRS Interactive TIN, Health Guide USA, NPI Registry, APA, and other online resources. - Manages all facets of VES' Credentialing process, and ensures each Provider is fully compliant with VES' contract with the VA. - Processes State licensure, background checks, VA training programs, billing paperwork, legal contracts, and academic information for Providers. - Inputs VES providers' credentialing, personal, legal, fiscal, medical, academic, and contact information into VES' operating system (OMS), and creates a profile for each provider who has been 100% credentialed with VES. Additional Duties and Responsibilities: - Maintain frequent communication with Provider Recruiters with regard to the credentialing status of each provider that they recruit. - Periodically audit Providers' profiles in OMS for accuracy. - Manually maintain and keep up- to- date all active providers' profiles and information within OMS. - Must have a complete understanding in VES' credentialing paperwork and in the VA's credentialing paperwork and trainings, and must field any questions from providers or Provider Recruiters about said paperwork and trainings. - Other duties as assigned. Knowledge/Skills/Abilities: - Advanced reading and comprehension abilities. - Advanced analytical skills and detail- oriented. - Advanced multi- tasking skills, with ability to remain focused on individual tasks in fast- paced environment. - Advanced organizational and prioritization skills, with strong ability to meet strict deadlines. - Proficient typing skills. - Proficient with Microsoft Word, Microsoft Outlook, Adobe Acrobat, general internet research, and beginner knowledge of Microsoft Excel. Please note: With this position you have the option to have Maximus provide you with equipment to use, or you may use your own equipment. Home Office Requirements Using Your Own Equipment:
  • Internet speed of 20mbps or higher required (you can test this by going to )
  • Preferred Windows or Mac (no Chromebooks)
    • OS for Windows - Windows 10 or newer
    • OS for Mac - Big Sur (11.0.1+); Catalina (10.15); MacOS (up to 12.5) or newer
  • Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router
  • USB plug and play wired headset with a microphone and noise suppression
  • Private work area and adequate power source
  • A second monitor is highly recommended for most positions
  • Must currently and permanently reside in the Continental US
Home Office Requirements Using Maximus-Provided Equipment:
  • Internet speed of 20mbps or higher required (you can test this by going to )
  • Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router
  • Private work area and adequate power source
  • Must currently and permanently reside in the Continental US
Minimum Requirements Minimum Qualifications: High school graduate; some college preferred; Customer service experience preferred. EEO Statement Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We're proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
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