Credentialing Specialist
symplr
Credentialing Specialist
- ID
- 2025-2045
- Category
- Credentialing
- Position Type
- Regular Full-Time
- Min
- USD $20.00/Hr.
- Max
- USD $24.00/Hr.
Overview
Credentialing Specialists work to ensure verification of the professional licensing, training, and certifications of professional licensed independent practitioners, Advanced Practice Professionals, and others. Their primary goal is to ensure healthcare professionals and services meet all established federal and state standards, as well as NCQA (National Committee for Quality Assurance) standards. This is a fully remote opportunity.
Duties & Responsibilities
- Compile confidential, accurate primary sourced data to facilitate customers in the decision-making process for practitioners/providers with health care plans, hospitals, surgery centers and/or other health care institutions. Position requires extensive, direct interaction with health plans, government agencies, practitioners/providers, and customers.
- Process, review and maintain all practitioner/provider credentialing and re-credentialing files and offer solutions regarding the workflow of credentialing files.
- Enter and update practitioner/provider data in the credentialing database while adhering to input standards.
- Processes complete initial and re-credentialing applications within the expected timeframes.
- Perform primary source verification in accordance with customer needs and applicable industry standards.
- Assure the confidentiality and integrity of all aspects of the credentialing program and process.
- Perform a variety of essential administrative functions for all aspects of the credentialing, and follow up processes.
- Must be able to interpret and communicate primary sourced data/information in a timely manner and understand current state and federal regulatory requirements, accreditation standards, as they pertain to primary source verification functions.
Skills Required
- Solid working knowledge of credentialing software applications and/or other relational databases like Access.
- Excellent organizational skills.
- Superior customer service skills.
- Excellent communication skills - both verbal and written.
- Understands the importance of customer follow up and attention to detail.
- Must be highly organized and able to work efficiently and effectively in a fast-paced environment.
Qualifications Required:
- Must have at least one year of Primary Source Verification experience and be able to speak to the databases used for PSV.
- Direct and recent working experience dealing with healthcare credentialing in a hospital, CVO or other setting where adherence to policy and other regulatory standards are essential.
- Certification as a CPCS (Certified Provider Credentialing Specialist) by NAMSS preferred but not required.
Min
Max
Options
The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.
Applicants must be authorized to work in the U.S. on a full-time basis without the need for current or future sponsorship.
About symplr:
symplr is revolutionizing healthcare operations with a first-of-its-kind platform that drives effective, efficient, and connected workflows while increasing operational benefits and scaling clinical, financial, and quality outcomes—driving value where it matters most.
We are a remote-first company with employees working across the United States, India, and the Netherlands. Guided by values, we focus on teamwork, championing our customers, being rooted in action and outcomes, overcoming challenges, and leading through equality and integrity. Read more about symplr's culture and values at symplr.com/careers.
Perks & Benefits:
- Company Sponsored Medical, Dental & Vision
- Safe Harbor 401K with Employer Matching up to 5%, eligible upon hire with immediate vesting
- HSA Employer Contributions, Employer Paid Life, Short-term and Long-term Disability, and AD&D Insurance Plans
- Permissive Time Off Plans, Volunteer Time Off, & 12 Paid Holidays
- Fully Paid Medical Leaves of Absence and Bonding Leaves for new parents
- Tuition Assistance & Continuing Education Reimbursement available
- Additional Employer-Paid Programs: Cleo Family Services, Care@Work Memberships, Headspace Memberships, LifeMart Discounts, and more!
symplr is an Equal Opportunity/Affirmative Action Employer. We consider applicants without regard to race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other group protected by federal, state or local law.
As an ongoing commitment to reasonably accommodate individuals with disabilities, symplr has established alternative methods to complete the application process. Disabled applicants needing assistance are encouraged to call 281.863.9500 if further assistance is required.
To all recruitment agencies: we do not accept resumes or partnership opportunities. Please do not forward resumes to symplr or any of our employees. We are not responsible for any fees related to unsolicited resumes.
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