Job Description
Spherion Staffing has several openings for Credentialing Specialists. The Credentialing Specialist is responsible and accountable for oversight of tasks and processes developed to facilitate the credentialing process for initial and reappointment applications to medical staff, professional health staff and allied health staff.
Schedule: Monday-Friday, 8am-5pm
Worksite: Either onsite or remote (SD, ND, MN, IA)
Dress Code: business casual, jeans allowed (no rips/holes)
Assignment length 13 weeks
Responsibilities:
-Process initial credentialing and re-credentialing applications for healthcare providers
-Verify provider qualifications, including licenses, certifications, education, training, and work history
-Ensure compliance with federal, state, and industry regulations (e.g., CMS, NCQA, Joint Commission, HIPAA)
-Maintain accurate and up-to-date provider information in credentialing databases
-Oversee the timelines and workflow processing of the reappointment cycles
-Prioritize work to meet anticipated start dates and reappointment expiration
-Accountable for the completeness and identifying issues requiring additional information or investigation on applications
-Oversee the accuracy of application data entry and verification requests
-Perform the final review of processed verifications for quality and content
-Develop correspondence to obtain additional information as needed
-Facilitate committees in preparation of agenda materials and follow-up of recommendations
-Coordinate communication of final credentialing recommendations to all parties
-Generate audits and reports to support/document the verifications and credentialing process
Working hours: 8:00 AM - 5:00 PM
Skills:
See below
Education:
High School
Experience:
1-4 years
Qualifications:
-1-3 years of experience in provider credentialing, healthcare administration, or a related field preferred
-Excellent customer service skills and ability to take initiative to meet the needs of all to ensure customer focus and a positive experience
-Ability to communicate effectively and with a high level of diplomacy with providers
-Must be able to work on multiple daily tasks with efficiency and high-quality accuracy while handling multiple internal and external customer communications
-Responsible for planning work to meet regulatory and customer defined deadlines, which requires coordination to minimize redundancy of work when multiple organizations share common providers
To be considered, please apply online at or if you have questions you can reach out to Greg Stafford at 605-335-6010
Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Spherion, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact Callcenter@spherion.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Spherion offers a comprehensive benefits package, including health, and an incentive and recognition program (all benefits are based on eligibility).
key responsibilities
-Process initial credentialing and re-credentialing applications for healthcare providers-Verify provider qualifications, including licenses, certifications, education, training, and work history-Ensure compliance with federal, state, and industry regulations (e.g., CMS, NCQA, Joint Commission, HIPAA)-Maintain accurate and up-to-date provider information in credentialing databases-Oversee the timelines and workflow processing of the reappointment cycles-Prioritize work to meet anticipated start dates and reappointment expiration-Accountable for the completeness and identifying issues requiring additional information or investigation on applications-Oversee the accuracy of application data entry and verification requests-Perform the final review of processed verifications for quality and content-Develop correspondence to obtain additional information as needed-Facilitate committees in preparation of agenda materials and follow-up of recommendations-Coordinate communication of final credentialing recommendations to all parties-Generate audits and reports to support/document the verifications and credentialing process
experience
1-4 years
skills
See below
qualifications
-1-3 years of experience in provider credentialing, healthcare administration, or a related field preferred-Excellent customer service skills and ability to take initiative to meet the needs of all to ensure customer focus and a positive experience-Ability to communicate effectively and with a high level of diplomacy with providers-Must be able to work on multiple daily tasks with efficiency and high-quality accuracy while handling multiple internal and external customer communications-Responsible for planning work to meet regulatory and customer defined deadlines, which requires coordination to minimize redundancy of work when multiple organizations share common providers
education
High School Spherion
Job Tags
Permanent employment, Temporary work, Work experience placement, Casual work, Monday to Friday,