Medical Credentialing Specialist Job at Robert Half (Indianapolis)

Medical Staff Credentialing Specialist and Coordinator

The Medical Staff Credentialing Specialist and Coordinator assists the Medical D...

Location

United States , Medina

Salary:

50000.00 - 60000.00 USD / Year

Orleans Community Health

Expiration Date

Until further notice

Requirements

Associates Degree or Certified Provider Credentialing Specialist (CPCS)
A minimum of 2-3 Years Credentialing experience is preferred
Excellent verbal and written communication skills, ability to relate well with people of diverse backgrounds, training and experience
Proficiency with medical practice software programs, Familiarity with credentialing requirements of hospitals and insurance carriers
Understanding of Malpractice insurance coverages and policies
Knowledge and understanding of credentialing process
Ability to organize and prioritize work and manage multiply priorities
Ability to research and analyze data
Ability to work independently with minimal supervision
Ability to establish and maintain effective working relationships with providers, management, staff and external contacts

Job Responsibility

Compiles and maintains current and accurate data for all providers
Completes provider credentialing and re-credentialing applications, monitors applications and follow-up as needed
Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
Maintains corporate provider contract files
Maintains knowledge of current health plan and agency requirements for credentialing providers
Sets up and maintains provider information in online credentialing databases and system
Tracks license and certification expirations for all providers to ensure timely renewals
Ensures practice addresses are current with health plans, agencies and other entities
Audits health plan directories for current and accurate provider information
Completes credentialing/re-credentialing application packets for hospital, insurance carriers and government programs

What we offer

vacation and sick time
health, dental and vision
pension and retirement plan
competitive wages, with superior pension and retirement plans with employer contributions
12% shift differential for working evening and night shifts
excellent vacation, holiday and sick leave package
tuition assistance
free parking

Fulltime

Credentialing Specialist

We are looking for a detail-oriented Credentialing Specialist to join our team o...

Location

United States , Henderson

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proven experience in credentialing, particularly in a healthcare or hospital setting
Proficiency in using credentialing databases, CRM systems, and EHR platforms
Familiarity with the Council for Affordable Quality Healthcare (CAQH) process
Strong knowledge of medical terminology and credentialing standards
Exceptional organizational and auditing skills with high attention to detail
Ability to manage multiple tasks and meet strict deadlines
Certified Provider Credentialing Specialist (CPCS) designation preferred
Proficiency in tools like Adobe Acrobat and Microsoft Office Suite

Job Responsibility

Manage the credentialing process by collecting, reviewing, and verifying applications and supporting documentation
Ensure all physician credentials are accurate, complete, and comply with applicable regulatory standards
Maintain up-to-date records in the credentialing database and other tracking systems
Collaborate with healthcare providers and organizations to resolve discrepancies or incomplete information
Conduct audits to verify compliance with internal policies and external regulatory requirements
Provide support for enrollment with the Council for Affordable Quality Healthcare (CAQH) and other accrediting bodies
Prepare detailed reports on credentialing activities and compliance status
Assist in identifying and implementing improvements to the credentialing process
Stay informed about changes in healthcare credentialing regulations and best practices

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Fulltime

Client Partner – Credentialing Specialist

Join our team in Manila as a Client Partner - Credentialing Specialist. We are s...

Location

Philippines , Taguig City

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Strong knowledge of Payer Processes and Credentialing
Willingness to work continuously in night shifts
Must be fluent in English language
Willing to work in the night shift at our office in McKinley Hill, Taguig
Must have at least 1 year of experience in Credentialing processes for US healthcare customers

Job Responsibility

Manage the end-to-end provider enrollment process, ensuring healthcare providers are properly credentialed and enrolled with insurance networks
Conduct thorough review of provider documentation, ensuring compliance with credentialing requirements and proactively resolving any discrepancies
Serve as a liaison between healthcare providers and insurance companies, addressing enrollment-related inquiries and facilitating timely resolution
Maintain accurate and up-to-date provider information in databases, and collaborate with internal teams to streamline the enrollment and billing processes

Credentialing Specialist

We are in search of a skilled Credentialing Specialist to join our team in South...

Location

United States , Southborough

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 5 years experience as a Credentialing Specialist or a similar role in the healthcare industry
Proficiency in computerized billing systems and electronic health record (EHR) systems
Experience with Epic Software
Solid understanding and experience in accounting functions, specifically in the healthcare setting
Expertise in medical credentialing and medical billing is essential
Proficiency in Microsoft Excel
Demonstrated experience in handling various billing functions
Familiarity with contractual billing, electronic billing, healthcare billing, insurance billing, Medicaid billing, medical insurance billing, Medicare billing, patient billing, physician billing, and third-party billing

Job Responsibility

Collect, review, and validate credentials for healthcare providers, including licenses, certifications, and education
Maintain and update credentialing databases and files for all healthcare providers, ensuring all required documents are current and complete
Adhere to all applicable laws, regulations, and industry standards (e.g., NCQA, CMS, etc.) associated with credentialing
Generate and maintain reports related to credentialing status and compliance and communicate any issues or discrepancies to management
Assist with the enrollment of providers and group facilities into insurance networks and maintain active status with payer organizations
Act as a liaison between healthcare providers, insurance companies, and internal departments to resolve credentialing issues or questions
Participate in internal and external audits of credentialing files, ensuring accurate and timely completion of necessary documentation
Stay informed of changes in regulatory requirements and best practices to ensure the credentialing process remains efficient and compliant
Uphold the dignity and respect of individuals we support and ensure they are treated in accordance with our Human Rights policies
Adhere to all principles related to the Advocates Way

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Credentialing Specialist Lead

The Credentialing Specialist Lead serves as the senior subject matter expert wit...

Location

United States , Long Island City

Salary:

30.00 - 32.00 USD / Hour

The Dermatology Specialists

Expiration Date

Until further notice

Requirements

3+ years of healthcare credentialing experience
dermatology or multispecialty experience preferred
Strong knowledge of CAQH, NPPES, Medicaid, Medicare, and commercial payer portals
Exceptional attention to detail, organization, and follow-through
Excellent communication and interpersonal skills
Proficiency in Excel and credentialing systems
experience with eClinicalWorks a plus

Job Responsibility

Manage the full credentialing lifecycle for physicians, NPs, and PAs — including Medicaid, Medicare, and commercial payer enrollments (Empire BCBS, Fidelis, Aetna, etc.)
Review and verify provider documents such as medical licenses, DEA, board certifications, malpractice coverage, and CVs
Prepare, track, and submit enrollment applications accurately and within payer timelines
Monitor revalidation and re-credentialing schedules to ensure ongoing compliance
Serve as the primary point of contact for escalated payer or provider inquiries
Partner with internal billing and operations teams to ensure credentialing aligns with billing readiness
Maintain credentialing logs, dashboards, and internal trackers for reporting purposes
Assist in training and supporting new credentialing specialists, ensuring quality and consistency across workflows

Credentialing Specialist II-Medical Staff

Performs and monitors all credentialing functions, including complex credentiali...

Location

United States , Tucson

Salary:

Not provided

Tucson Medical Center

Expiration Date

Until further notice

Requirements

High school diploma or general education degree (GED)
Two (2) to Four (4) years of medical staff privileging or credentialing experience
CPCS or CPMSM certification preferred
Intermediate to Advanced Knowledge of healthcare practices and procedures
Advanced Skills in maintaining a detailed database, creating reports, and maintaining files
Intermediate to Advanced Ability to read, analyze, and interpret general business periodicals, professional journals, technical and software related procedures and manuals, governmental regulations
Display promotes and inspires trust and confidence among team members and stakeholders through reliability, authenticity, and accountability
Expresses thoughts clearly, concisely, and effectively both verbally and in writing
Establishes and maintains productive and cooperative relationships with team members, peers, management, and stakeholders both internal and external to the organization
Intermediate to Advanced ability to effectively present information and respond to inquiries regarding any issue related to the Credentialing and Privileging process

Job Responsibility

Performs and monitors all credentialing functions, including complex credentialing issues and brings forward issues to the Medical Staff Credentialing Lead and/or Director
Interfaces with senior medical staff leaders and administration and presents information when necessary
Utilizes knowledge of bylaws, rules, and regulations, expertise, sound judgment to mentor and support Medical Staff Credentialing Specialists I, other peers, and leadership
Acts as a liaison between Administration and members of the Medical Staff
Apply knowledge, expertise, sound judgment and consult other references and resources as necessary to generate and evaluate solutions and recommendations
Applies knowledge of bylaws, rules, and regulations to effectively serve as a Medical Staff information resource, to ensure timely flow of work, and sound judgment to mentor and support Medical Staff Credentialing Specialists I, other peers, and leadership
Ensures compliance with all applicable Accreditation agencies
Supports oversite and participate in internal, external, compliance surveys, reviews and audits as required
Utilizes credentialing software for new and reappointment letters, resignations, leave of absences, changes in staff category, add/delete privileges
Coordinates, monitors and maintains the credentialing and recredentialing process

Fulltime

New

Credentialing Assistant

At Boston Children’s Hospital, the quality of our care – and our inclusive hospi...

Location

United States , Boston

Salary:

19.06 - 27.64 USD / Hour

Boston Children's Hospital

Expiration Date

Until further notice

Requirements

Coordinates and supports the Medical Staff Credentialing Specialists with the Medical Staff and House Staff credentialing processes
Processes initial and reappointment applications by tracking due dates, monitoring email, and routing documentation to the Specialist in accordance with policies and procedures, Joint Commission standards, National Commission for Quality Assurance (NCQA) standards, state and federal regulations, and Boston Children’s Hospital Medical Staff Bylaws and Rules and Regulations
Maintains paper and electronic confidential credentialing files for all members of the Medical Staff and House Staff
Generates standard or routine reports using the medical staff software database program
Creates and produces diplomas for House Staff Training Programs
Processes initial and renewal of Massachusetts Limited Medical Licenses in the BORIM online system as the Boston Children’s Hospital Designated Official for the Board of Registration in Medicine (BORIM) in accordance with the BORIM licensing requirements for trainees
Vets the Affiliating House Staff (Rotators)
Ensures affiliated house staff documentation is complete and processed according to established processes in a timely and efficient manner
Coordinates completion of documentation with departments and divisions, Human Resources, and other key stakeholders
Tracks the expiring document process, including Medical Licenses, Federal Drug Enforcement Agency (DEA) certification, Massachusetts Controlled Substances Registrations, and malpractice face sheets

What we offer

flexible schedules
affordable health, vision and dental insurance
child care and student loan subsidies
generous levels of time off
403(b) Retirement Savings plan
Pension
Tuition and certain License and Certification Reimbursement
cell phone plan discounts
discounted rates on T-passes

Fulltime

Credentialing Auditor

Responsible for auditing all complete credentialing applications and to build so...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

Bachelor's Degree preferred
High School or equivalent required
3 years of experience in medical staff and/or managed care credentialing preferred
Certified Provider Credentialing Specialist (CPCS) preferred

Job Responsibility

Coordinate and conduct credentialing audits analyzing provider files for completeness, accuracy, consistency, gaps in work history, relevant references, etc.
Prepare credentialing audit reports tracking and trending auditor findings and assist in the formulation of staff training guides, policies and procedures
Manages multiple concurrent audits, plan audits and related projects ensuring all audit tools comply with NCQA, TJC and CMS requirements
Coordinates the credentialing and re-credentialing process for assigned providers

Fulltime

Medical Credentialing Specialist

Robert Half

Location:
United States , Indianapolis

Category:
-

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
March 21, 2026

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