Credentialing Specialist

Description

 Job Title: Credentialing Specialist
Location: Grand Peaks St. Anthony
Employment Type: Full-Time (not remote) 

Wage: DOE

Grand Peaks is a patient focused, community health center committed to delivering high quality, comprehensive medical, dental, behavioral health and pharmacy services. We pride ourselves on fostering a supportive work environment where our team members can grow and thrive. We are currently seeking a detail oriented and organized Credentialing Specialist to join our team.

The Credentialing Specialist is responsible for managing and maintaining the credentialing and re-credentialing process for all healthcare providers within Grand Peaks. This position ensures compliance with regulatory requirements, health plan policies, and internal standards, supporting the timely and accurate onboarding and maintenance of provider credentials.

Key Responsibilities:

• Coordinate, process, and track initial credentialing, re-credentialing, and privileging applications for all healthcare providers
• Maintain and update provider files and credentialing databases
• Monitor licensure, certifications, and other time-sensitive documents to ensure compliance
• Verify provider qualifications, education, work history, and professional references
• Work closely with insurance companies, healthcare organizations, and internal departments to facilitate credentialing and contracting processes
• Ensure compliance with all applicable federal, state, and accreditation regulations 
• Prepare and submit credentialing reports and audits as needed
• Assist with provider enrollment and health plan applications
   

Requirements

 Qualifications:

• High school diploma or equivalent required; associate’s or higher degree preferred
• Prior experience in credentialing, healthcare administration, or medical office support preferred
• Strong attention to detail and organizational skills
• Ability to manage multiple deadlines and maintain accuracy in a fast-paced environment
• Familiarity with credentialing software, and Microsoft Office applications
• Knowledge of HRSA, FTCA, and health insurance credentialing guidelines is a plus

What We Offer:

• Competitive compensation
• Health, dental, and vision insurance
• Retirement plan options
• Paid time off and holidays
• Supportive, team-oriented work environment
• Opportunities for professional development and advancement
  

If you are a detail driven professional looking to build a career in healthcare administration, we would love to hear from you! Please submit your resume and professional references.