EEE QI - Credentialing Specialist-New Jersey Ave-DC
$60,400–$68,722 year
On-siteWashington, District of Columbia, United States or Washington, United States
Job Summary
Administer credentialing, re-credentialing, and delegated processes for healthcare providers and licensed staff by coordinating, monitoring, and maintaining accurate files. Perform regularly scheduled audits, analyze deficiencies, and resolve provider file issues while verifying licensure, education, training, and malpractice coverage. Collaborate with provider offices to obtain missing documentation, manage OneApp Pro and CAQH files, and process monthly re-credentialing for clinical and allied health roles. Generate weekly reports, monitor regulatory updates from HRSA, NCQA, and the Joint Commission, and respond to provider inquiries via phone, email, or written communication. Conduct onboarding verification for new hires and train new credentialing staff.
Required Qualifications
- Bachelor's degree OR an equivalent combination of education and experience that provides the required knowledge, skills, and abilities
- Three (3) or more years of healthcare credentialing experience OR equivalent combination of education and experience
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