Job Title: Credentialing and Privileging Specialist
Supervisor's Title: Credentialing & Privileging Manager
Department: Administration and Management
Pay Type: Salary
FLSA Status: Exempt
UDS Category: Management and Support Personnel
Pay Category: Adm-1b
Employment Type: Full Time
Position Summary:
The Credentialing Specialist ensures clinical staff maintain the licenses, certifications, and privileges required to practice legally and in compliance with organizational standards. This role exists to manage credentialing and renewal processes, maintain accurate documentation, and verify qualifications for new and existing staff. By overseeing these activities, the position supports regulatory compliance, patient safety, and operational readiness.
Supervisory Responsibilities:
Essential Functions:
Maintains compliance with all regulatory and accrediting institutions with particular attention to internal policies, state laws, and the Health Services and Resource Administration (HRSA) requirements for Federally Qualified Health Centers (FQHCs)
Monitors staff credentials and privileges and work with management to ensure continuous compliance
Develops, maintains, and utilizes tools to ensure compliance including electronic platforms
Supports and works with the insurance credentialing team to ensure efficient insurance credentialing
Assists with Risk Management projects as needed
Abilities:
Eager and able to embody the Mission, Vision, and Core Values of CCH
Able and willing to demonstrate love, compassion, and genuine care when interacting with others
Ability to work as part of a team with excellent interpersonal skills
Possess a high level of self-motivation and energy, and work with minimal supervision
Fosters working relationships with senior leadership and management
Ability to support multiple team members and projects simultaneously and prioritize
Skills:
Knowledgeable in Centers for Medicare & Medicaid Services (CMS) regulations
Strong working knowledge of state boards, CAQH, payer portals, and credentialing workflows
Proficiency in Adobe and/or FoxIt PDF as well as the Microsoft Office Suite which includes Word, Excel, PowerPoint, and Outlook
Analytical skills to receive, assemble and report on data records
Extremely attentive to details
High organizational and time management skills
Highly developed oral and written communication skills
Education and Experience:
At least three years of experience as professional support in health care, preferably in the medical staff services field (Required)
Two years of experience in credentialing, privileging, enrollment or similar healthcare professional verification and organization's accreditation processes (Preferred)
Certified Provider Credentialing Specialist (CPCS), Certified Professional Medical Services Management (CPMSM) or Certified Provider Enrollment Specialist (CPES) (Preferred)
Proficiency in using CredentialStream (VerityStream) (Preferred)
Work Conditions:
Rarely
(0-12%)
Occasionally
(13-33%)
Frequently
(34-66%)
Regularly
(67-100%)
Office: normal working conditions with the absence of disagreeable elements
X
Clinical: exposure to bodily fluids, bloodborne pathogens, & infectious diseases
X
Remote: work from home or location outside a central office
X
Outdoor/External: exposure to weather conditions & elements such as dirt, dust, oil, smoke, fumes, water
X
Extended hours: work performed beyond/outside operating hours
X
Travel required: use of a vehicle or other mode of transportation to complete tasks beyond arrival and departure to/from work
X
Physical Requirements:
Rarely
(0-12%)
Occasionally
(13-33%)
Frequently
(34-66%)
Regularly
(67-100%)
Seeing: Must be able to read documents and use computer
X
Hearing: Must be able to hear well enough to communicate with coworkers
X
Standing/Walking
X
Climbing/Stooping/Kneeling
X
Lifting/Pushing/Pulling: at least 15 pounds at a time
X
Sitting: prolonged periods of sitting
X
Fingering/Grasping/Feeling: Must be able to write, type, and use phone system
X
Attire:
Clinical/Scrubs
Maintenance/Trade
Business Casual
X
Note: The statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.
Company Background:
Our Mission: To proclaim Jesus Christ as Lord and to demonstrate His love by providing affordable, quality primary health care to the underserved.
Our Vision: In response to God's grace, we desire to be a part of the redemptive work of Christ to the economically, socially, and spiritually impoverished communities of Augusta, Georgia.
About: Christ Community Health Services Augusta (CCH) is a rapidly growing, primary care health clinic and a community and faith-based 501 (c) (3) organization serving families in a ten-county region between Georgia and South Carolina.
As our patient population continues to grow throughout the greater Augusta area, we are in search of a caring and competent team members to join our team! Our four clinics (five, including dental) are strategically located in urban Augusta neighborhoods, providing local access to affordable care for patients who face medical, economic and transportation hardships. As a federally qualified health center and certified patient-centered medical home, we accept patients with no insurance, Medicare, Medicaid and most commercial insurance plans.
Our services include:
Christ Community Health aims to share Christ's love through healing of the body, mind, and soul. We hope you'll consider joining us in this ministry. Help us meet the needs of others in our community! Working at Christ Community, you'll find community, vocational purpose, and a place to grow in the health care field.
What Christ Community has to offer:
CCH is committed to understanding the needs of its staff and recognizing that there's more to an employee than just what happens during the typical work week. Because of that, we strive to offer a compensation package that includes a competitive salary; employer-paid medical, life, short-term disability, and long-term disability insurance; available 401k plan with employer matching. Additional benefits include dental and vision insurance, paid time off, paid holidays, flexible spending accounts, employee care credit, uniform allowances, tuition assistance, and more. We are also a qualifying employer under HRSA-funded loan repayment and Public Service Loan Forgiveness (PSLF) program. Join our team today!
Christ Community Health Services Augusta Inc. is an Equal Opportunity Employer and does not discriminate on the basis of race, sex, color, age, national origin, marital status, disability, veteran status, sexual orientation, gender identity or any other federal, state, or local protected class.