Credentialing Specialist - Remote

Overview

The Credentialing Specialist is responsible for all aspects of the credentialing, re-credentialing, and privileging processes for all providers in Privia’s high-performance medical group.

In Short

• Ensure timely processing of Primary Source Verification for initial and recredentialing.
• Align with NCQA, CMS, and state requirements for provider credentialing.
• Resolve complex provider credentialing issues with stakeholders.
• Support special projects related to health plan requirements.
• Maintain up-to-date provider data in credentialing databases.
• Ensure confidentiality of provider information.
• Manage information flow between internal stakeholders.
• Coordinate and prepare reports under manager supervision.
• Record and track credentialing statistics.
• Other duties as assigned.

Requirements

• 1+ years experience in managed care credentialing.
• Strong problem-solving and analytical skills.
• Ability to function independently and manage multiple projects.
• Comply with HIPAA rules and regulations.
• Effective communication with practitioners and stakeholders.
• High attention to detail and organizational skills.
• Exercise independent judgment in interpreting regulatory guidelines.

Benefits

• Medical, dental, vision, and life insurance.
• 401K plan.
• Paid time off.
• Wellness programs.
• Annual bonus targeted at 10%.