Demo

Specialist, Credentialing

The Wright Center for Graduate Medical Education
Scranton, PA Full Time
POSTED ON 4/25/2025
AVAILABLE BEFORE 6/25/2025

Description

POSITION SUMMARY
The Credentialing Specialist is responsible for all aspects of the initial credentialing, re-credentialing, privileging and overseeing the credentialing portion of the new hire on-boarding process for all incoming Physicians, Nurse Practitioners and Physician Assistants. Responsible for the application process which includes maintenance of the online application site and forms repository and intake, review and appropriate routing of all credentialing documents. Responsible for the insurance/billing and facility credentialing. This position liaises with both internal and external agencies involved in the credentialing process. Also liaises with programs, hospitals and applicants regarding any required follow up or notification. 


In addition to credentialing of providers, position will maintain certifications, licenses, DEAs and CMEs for medical staff.

Work is typically performed in an office environment, but this position has the option to work from home with participation in customer/community services activities as needed. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements for this job description are not intended to be all inclusive. They represent typical elements considered necessary to successfully perform the job.


ESSENTIAL JOB DUTIES AND FUNCTIONS

While living and demonstrating our Core Values, the Credentialing Specialist will:

  • Maintain credentialing and competency files in an orderly and current manner
  • Appropriate boards and certifying agencies are contacted to assure current and accurate information is maintained on an ongoing basis
  • Documents are filed timely and accurately in the credentials and competency files
  • Data is entered in the credentialing management system timely and accurately
  • Prepare information for Credentialing review
    • Ensure credential file is in order with any issues of concern flagged
    • Assist with research and preparation of documents to support development of clinical privilege criteria
    • Prepare for internal and external audits conducted for current and accurate provider information
  • Assist with projects related to credentialing and privileging functions and maintains institutional tracking system of privileges
    • Review and interprets applicable accreditation, licensure, and other regulatory requirements to ensure the organization's bylaws and policies meet requirements.
    • Design and update forms and checklists, including but not limited to, application forms, clinical privilege documents, checklists, etc.  
  • Maintain confidentiality of credentialing information
    • Release of confidential credentialing information is limited to persons in a need/right to know position.
  • Maintain certifications (ACLS, BLS, PALS. Etc.), CMEs, Licenses and DEAs for all Faculty and clinical staff
  • Improve professional growth and knowledge related to job-specific competencies. 
  • Independently seeks out and utilizes information resources
  • Participates in the design, implementation, and ongoing management of performance improvement activities
  • Demonstrates commitment to continuous performance improvement

Requirements

REQUIRED QUALIFICATIONS

  • Bachelor’s degree or equivalent experience 
  • Minimum 5 years of experience working in a medical facility environment or healthcare background
  • Working knowledge of medical terminology, insurances and billing
  • Experience with electronic medical records
  • Excellent communication skills in one-on-one interactions, electrically and over the phone
  • Ability to perform the role successfully in a high-intensity environment
  • Strong computer skills specifically Microsoft Excel
  • Must be a time driven individual who can meet many deadlines with a variety of outside parties
  • Must be extremely organized and successfully monitor the status of many concurrent deadlines
  • Meet The Wright Center for Community Health and its affiliated entity The Wright Center for Graduate Medical Education EOS© People Analyzer Tool
  • Buy in and experience working in the EOS® model (strongly preferred)
  • Mission-oriented; represents the enterprise in a professional manner while demonstrating organizational pride

If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

What is the career path for a Specialist, Credentialing?

Sign up to receive alerts about other jobs on the Specialist, Credentialing career path by checking the boxes next to the positions that interest you.
Income Estimation: 
$45,655 - $57,431
Income Estimation: 
$52,651 - $65,671
Income Estimation: 
$45,655 - $57,431
Income Estimation: 
$52,651 - $65,671
Income Estimation: 
$52,651 - $65,671
Income Estimation: 
$70,470 - $90,625
Income Estimation: 
$98,508 - $127,023
Income Estimation: 
$163,457 - $212,608
Income Estimation: 
$70,470 - $90,625
Income Estimation: 
$98,508 - $127,023

Sign up to receive alerts about other jobs with skills like those required for the Specialist, Credentialing.

Click the checkbox next to the jobs that you are interested in.

  • Concept Development Skill

    • Income Estimation: $70,684 - $92,141
    • Income Estimation: $69,778 - $97,698
  • Conceptual Design Skill

    • Income Estimation: $70,684 - $92,141
    • Income Estimation: $71,252 - $93,927
View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

Job openings at The Wright Center for Graduate Medical Education

The Wright Center for Graduate Medical Education
Hired Organization Address Jermyn, PA Full Time
Description POSITION SUMMARY The primary focus will be the practice of dentistry, including examining, diagnosing, and d...
The Wright Center for Graduate Medical Education
Hired Organization Address Jermyn, PA Full Time
Description POSITION SUMMARY Geriatric Psychiatrist will focus on the prevention, evaluation, diagnosis and treatment of...
The Wright Center for Graduate Medical Education
Hired Organization Address Barre, PA Full Time
Description POSITION SUMMARY The Dental Administrative Assistant (DAA) serves as the initial point of contact for patien...
The Wright Center for Graduate Medical Education
Hired Organization Address Scranton, PA Full Time
Description The Vice President, Chief Operating Officer Administrative and Population Health (VP/COOAPH) is a senior lea...

Not the job you're looking for? Here are some other Specialist, Credentialing jobs in the Scranton, PA area that may be a better fit.

Northeast Credentialing Specialist

Rezolut, Hazleton, PA

Northeast Credentialing Specialist

Rezolut, Kingston, PA

AI Assistant is available now!

Feel free to start your new journey!