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Senior Credentialing Specialist

ID
2026-2332
Category
Credentialing
Position Type
Regular Full-Time
Min
USD $24.00/Hr.
Max
USD $28.00/Hr.

Overview

The Senior Credentialing Specialist contributes to the ongoing achievement of the organization's goals through ensuring providers are credentialed using vetted processes and procedures. Identifies, analyzes, and resolves information, discrepancies, and time gaps that could adversely affect a facility's ability to credential and privilege providers. Partners with medical staff, credentialing and privileging committees, and other key stakeholders to ensure compliance with credentialing standards. Responsible for maintaining accurate and comprehensive data in the credentialing software.

 

The Senior Credentialing Specialist must have overall knowledge of the credentialing and privileging process, know the required credentials for health care professionals and can utilize the appropriate resources to complete Prime Source Verification (PSV) and databank queries. Senior Credentialing Specialists demonstrate a thorough knowledge on credentialing policies, guidelines, and regulations for the CVO credentialing process.

Duties & Responsibilities

  • Handles and oversees the processing of provider applications and re-applications
  • Maintains accurate provider profiling system data
  • Communicates with providers concerning credentialing status
  • Responds to requests for provider information
  • Enforces regulatory compliance and quality assurance
  • Support, in conjunction with the QA Team, any adverse action activities in accordance with regulations and policies
  • Prepare documentation, conduct, and conclude credentialing and privileging
  • Work, in conjunction with leadership, to identify potential 'pitfalls' in the CVO credentialing process
  • Meet productivity standards as outlined in CVO and client metrics

 

Skills Required

  • Strong interpersonal skills-works well with a team
  • Strong oral and written communication skills
  • Strong conflict resolution skills
  • Exceptional attention to detail
  • Exceptional analytical skills
  • Customer interaction experience

 

Qualifications Required:

  • Bachelor's Degree and/or equivalent work experience
  • 3 plus years of experience in medical credentialing
  • Strong knowledge of industry standards, to include but not limited to: TJC, NCQA, AAAHC and DNV
  • Strong knowledge of the Microsoft office suite to include Excel
  • Affinity to multi-task
  • Certification Preferred: CPCS

Min

USD $24.00/Hr.

Max

USD $28.00/Hr.

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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.