Job Description

As a Credentialing Specialist, you will be the backbone of our credentialing and re-credentialing processes for practitioners. In this pivotal position, you will:

• Process credentialing applications and maintain the credentialing database in alignment with our policies and procedures.
• Ensure all credentialing processes meet state statutes and comply with regulatory agencies such as NCQA, URAC, CMS, The Joint Commission, and the Arizona and Utah Department of Health Services (DHS).
• Generate tracking reports for expiring licenses and certifications, while conducting internal and external credentialing file audits.
• Collaborate with HR, Quality Management (QM), and the Business Office as a liaison to streamline credentialing workflows.
• Assist in tracking and renewing licenses, professional liability, and certifications for all providers, ensuring seamless compliance.

We’re looking for someone who brings expertise, enthusiasm, and commitment to the table:

• A minimum of 3 years of hospital credentialing, preferably with knowledge of CMS, AHCCCS, NCQA, URAC, and The Joint Commission guidelines.
• Education: High School Diploma or equivalent required; an Associate's Degree is preferred.
• Certification: Certified Practitioner Credentialing Specialist (CPCS) is a plus.
• Skilled in PECOS, CAQH

Location: Onsite in Phoenix, AZ 85016.

Schedule: Monday to Friday, with flexible start times between 7 AM and 9 AM, ensuring work-life balance.

Open ended contract with potential conversion.

Benefits include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, an EAP program, commuter benefits, and a 401K plan. Our program allows employees to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

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