Credentialing Specialist
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Job Description
Part-time credentialing specialist supporting Choctaw Advantage Solutions’ Air Force Family Advocacy Program. Managing provider credentials, verifications, compliance documentation, and privileging processes.
Responsibilities:
- Manage full-cycle credentialing and re-credentialing activities for clinical and ancillary providers
- Conduct primary source verification of licensure, education, training, certifications, and employment history
- Collect, review, and maintain credentialing documentation and provider files
- Upload and maintain documentation in the MD-Staff-approved credentialing software system
- Conduct NPDB queries, sanctions checks, background checks, and other required screenings
- Prepare and submit credentialing packets to military treatment facilities and applicable governing or oversight organizations
- Coordinate provider privileging and appointment processes with military treatment facility personnel and other stakeholders
- Track licenses, certifications, and expirable credentials to ensure timely renewals and continued compliance
- Communicate with providers and third-party organizations to obtain missing or incomplete documentation
- Conduct periodic audits of credentialing files for accuracy, completeness, and compliance
- Collect, analyze, and report credentialing data and compliance metrics
- Prepare reports on credentialing status, timelines, and compliance
- Identify process improvement opportunities and make recommendations
- Remain current on credentialing requirements, regulations, standards, and best practices
- Perform other duties as assigned
Requirements:
- High school diploma or equivalent
- At least one (1) year of healthcare credentialing experience
- Experience processing credentialing applications, primary source verifications, and compliance documentation
- Experience using MD-Staff software is highly preferred
- Knowledge of credentialing processes, primary source verification, and regulatory compliance
- Familiarity with healthcare accreditation standards and credentialing best practices
- Strong attention to detail and ability to manage high-volume, deadline-driven workflows
- Proficiency with Microsoft Office and credentialing and/or database systems
- Associate degree in Healthcare Administration, Business Administration, or a related field preferred
- Experience with DoD, DoW, or DHA credentialing requirements and systems preferred
- Experience supporting credentialing activities at a military treatment facility preferred
- Credentialing certification such as Certified Provider Credentialing Specialist (CPCS) preferred
- Familiarity with NCQA and/or Joint Commission standards preferred
- Experience with additional credentialing software platforms preferred
- Ability to manage multiple providers, requirements, deadlines, and expiring credentials
- Ability to communicate professionally with providers, government personnel, internal stakeholders, and external organizations
- Ability to prioritize competing deadlines in a high-volume environment
- Ability to identify missing information and resolve issues
- Understanding of confidentiality and protection of sensitive provider and healthcare information
Benefits:
- Part-time contract position
- 15 to 25 hours per week, not to exceed 30 hours per week
- Opportunity to support programs benefiting Service Members and their families
- Work as part of a professional team dedicated to quality, compliance, and exceptional service
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