Credentialing Specialist

Nuvance Health

Danbury, CT

JOB DETAILS
SALARY
$21.49–$41.73 Per Hour
SKILLS
Analysis Skills, Background Investigation, Centers for Medicare and Medicaid Services (CMS), Cerebral Vascular Accident, Certified Provider Credentialing Specialist (CPCS), Change Requests/Orders, Communication Skills, Congestive Heart Failure, Data Entry, Database Optimization, Establish Priorities, External Audit, Healthcare, Healthcare Quality, Hospital, Identify Issues, Internal Audit, Maintain Compliance, Medical Treatment, Microsoft Excel, Microsoft Outlook, Microsoft Word, National Committee for Quality Assurance (NCQA), Neonatal Intensive Care Nurse (NIC), News Reporting, News and Media, Nonprofit, Operations Processes, Performance Analysis, Psychiatry and Mental Health, Regulations, Regulatory Compliance, Reporting Skills, Team Player, Time Management, Utilization Review Accreditation Commission (URAC)
LOCATION
Danbury, CT
POSTED
30+ days ago

Credentialing Specialist in Danbury, CT, United States

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Credentialing Specialist

Location: Danbury, CT, United States

Salary Range: 21.49 - 41.73

Work Type: Full-Time

Standard Hours: 40

FTE: Non-Exempt

Work Schedule: Day 8

Work Shift: Monday - Friday, 8am - 4:30pm

Date Posted: Apr 17, 2026

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See what's possible in our system of care

Nuvance Health extends from New York's Hudson Valley to western Connecticut. Our team of more than 15,000 caregivers delivers compassionate care through seven community hospitals, primary care and specialty practice locations, outpatient settings, home care services and telehealth visits. With strong hearts and open minds, we're pushing past boundaries and challenging the expected, all in the name of possibility. As we journey forward, we are guided by our values: personal, imaginative, agile and connected. Our curiosity is opening new pathways and creating new advancements in healthcare for all.

Description

At Nuvance Health, we enjoy the benefits of a two-state system as we cultivate an inclusive culture where everyone feels welcomed, respected and supported. Together, we are a team of 15,000+ strong hearts and open minds. If you share our values of connected, personal, agile and imaginative, we invite you to discover what's possible for you and your career.

Danbury Hospital, a 456-bed acute care hospital, has been providing award-winning, personalized patient care to the people of Western Connecticut for 140 years. Our specialty areas of excellence include a Level III NICU, a certified Thrombectomy-Capable Stroke Center, and compassionate psychiatric care, including a partial-hospitalization program.

Our accolades include the following:

  • The Leapfrog Group - Grade A for quality and patient safety
  • U.S. News & World Report - High performance in heart failure treatment
  • Healthgrades - One of America's 50 Best Hospitals
  • Surgical Review Corporation (SRC) - Robotic Center of Excellence
  • Joint Commission - Gold seal of approval in spine surgery

At Danbury Hospital, we take great pride in our team members and their passion for providing the best care possible-always with heart. For many of our team members, that care extends beyond the walls of our hospital. We volunteer at local non-profits and participate in community initiatives and events. Our dedication to the health and well-being of our entire community makes this a truly special place to work.

Summary:

Responsible for ensuring the timely and efficient credentialing, including initial appointment, reappointment and privileging of all new and standing medical staff members in order to be in compliance with regulatory bodies (Joint Commission, NCQA, URAC, CMS, federal and state), as well as the Medical Staff Bylaws, Rules and Regulations, policies and procedures and delegated contracts.

Responsibilities:

  1. Prepares, disseminates, collects, reviews and processes applications for appointment and reappointment, and accompanying documents, ensuring applicant eligibility.

  2. Conducts thorough background investigation, research and primary source verification of all components of the application file, including retrieval of National Practitioner Database Reports in accordance with the Health Care Quality Act.

  3. Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow-up and closure.

  4. Prepares and completes credential files for review by the appropriate department chair and presentation at relevant Medical Staff Committees, ensuring file completion within time periods specified.

  5. Reviews and processes request for change in privileges, ensuring compliance with the Medical Staff Bylaws, Credentials Policy, and criteria outlined in clinical privilege descriptions.

  6. Reviews and processes requests for change in staff status, ensuring compliance with the Medical Staff Bylaws and Credentials Policy

  7. Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issue as they arise.

  8. Assists with credentialing audits by internal and external surveyors.

  9. Utilizes the credentialing database, optimizing efficiency, and performs data entry, query, report and document generation.

  10. Adheres to the credentialing and privileging process for assigned medical staff members, ensuring compliance with regulatory bodies (Joint Commission, NCQA, URAC, CMS, federal and state), as well as the Medical Staff Bylaws, Rules and Regulations, policies and procedures and delegated contracts.

  11. Creates, updates, and disseminates to relevant individuals within the organization, detailed reports on credentialing activities.

  12. Collects appointment and reappointment application fees, annual medical staff dues and reappointment fines.

  13. Performs miscellaneous job-related duties as assigned.

  14. Fulfills all compliance responsibilities related to the position.

  15. Performs other duties as assigned.

Education: HS GRAD/EQUIVALENT

Other Information:

Required: Proficiency in the use of credentialing databases and MS Word, Excel and Outlook. Ability to: communicate effectively, both orally and in writing; work effectively in a team environment; plan, prioritize and work multiple actives and tasks effectively, to produce work in high quantity and quality; to analyze, interpret and draw inferences from research findings and to prepare reports; to use independent judgment to manage and impart confidential information. Must have knowledge of related accreditation and certification requirements, to have knowledge of medical credentialing and privileging procedures and standards, working knowledge of clinical and /or hospital operations and procedures, database entry and management skills including querying, reporting and document generation.

Essential:

  • Certified Provider Credentialing Specialist

Minimum Experience: three years

Desired: Associate''s degree desired.

Credentials: CPCS

Company: Nuvance Health

Org Unit: 2095

Department: Credentialing

Exempt: No

Salary Range: $21.49 - $41.73 Hourly

With strong hearts and open minds, we're pushing past boundaries and challenging the expected, all in the name of possibility. We are neighbors caring for neighbors, working together as partners in health to improve the lives of the people we serve. If you share our passion for the health of our communities, advance your career with Nuvance Health!

Additional Salary Detail

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).

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We are an equal opportunity employer

Qualified applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation or our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to ensure that you are considered for current or future opportunities.

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