Credentialing Specialist

Western Michigan University Homer Stryker M.D. School of Medicine (WMed) is seeking a highly skilled and detail-oriented Credentialing Specialist to join our Human Resources team. This role serves as a key operational partner in provider credentialing, re-credentialing, and payer enrollment activities, supporting the successful onboarding and ongoing compliance of faculty and clinical providers across the institution.

As a subject matter expert, the Credentialing Specialist is responsible for managing complex credentialing processes with a high degree of accuracy, timeliness, and professionalism. This position plays a critical role in ensuring provider readiness, regulatory compliance, and continuity of revenue cycle operations while partnering collaboratively with internal departments, hospital partners, payers, and external agencies.

The ideal candidate will thrive in a fast-paced, mission-driven academic medical environment and demonstrate strong organizational skills, critical thinking, customer service, and the ability to manage multiple priorities while maintaining strict confidentiality and compliance standards.

BENEFITS

• Wellness reimbursement.

• Continuing education and tuition reimbursement.

• Employer-funded retirement plan.

• Two medical plan options: PPO and High Deductible Health Plan (HDHP) with employer HSA contribution.

• Flexible work solutions based on position and department.

• Up to four weeks of PTO accrual beginning in year one.

• Paid holidays.

• Paid volunteer time.

• Paid preferred holiday.

DUTIES AND RESPONSIBILITIES:

• Own and manage the end-to-end credentialing and re-credentialing lifecycle for providers, ensuring accuracy, completeness, and timeliness in alignment with regulatory and organizational standards.
• Serve as a primary liaison and subject matter expert for credentialing processes across internal departments, executive leadership, and external partners.
• Complete payer enrollment processes, including application preparation, submission, tracking, escalation, and resolution of delays impacting provider billing readiness.
• Conduct and validate primary source verifications in accordance with regulatory requirements.
• Prepare, audit, and present credentialing files and provider packets for Credentials Committee and Board of Directors review.
• Develop, maintain, and improve tracking systems, and credentialing workflows.
• Provide guidance and support to providers and leadership on credentialing requirements, timelines, and best practices.
• Partner with Talent Acquisition, hiring managers, and internal teams to ensure seamless provider onboarding.
• Track and manage expiring licenses, certifications, and credentials, ensuring proactive renewal and compliance.
• Identify opportunities for process improvement, standardization, and potential automation, contributing to operational excellence.
• Stay current on regulatory updates and best practices.
• Support audits, surveys, and accreditation reviews, serving as a key contributor during external evaluations.
• Availability to work occasional overtime on weekends or evenings to complete time sensitive projects.
• Acquires knowledge for new technology and policy/procedure revisions.
• All other duties as assigned.

EDUCATION AND/OR EXPERIENCE:

• Associate's degree in health information management, healthcare administration, business administration or equivalent combination of education and experience required.
• Minimum of three years' experience in in provide credentialing, privileging, and/or payer enrollments.
• Experience with Qgenda preferred.

LICENSES, REGISTRATIONS, CERTIFICATIONS:

• Certification such as CPCS (Certified Provider Credentialing Specialist) or CPMSM strongly preferred.

OTHER SKILLS AND ABILITIES:

• Knowledge of credentialing standards, regulatory requirements, and basic medical terminology.
• Strong analytical and problem-solving skills with the ability to identify process gaps and implement improvements.
• Basic organizational and project management skills with the ability to manage multiple high-priority deadlines simultaneously.
• High attention to detail.
• Proven ability to handle sensitive and confidential information with discretion.
• Adept knowledge of organizational operations and policy.
• Excellent organizational, analytical, and critical thinking skills.
• Must be proactive, innovative, and a quick learner.
• Strong teamwork and collaborative skills along with a strong customer focus.
• Advanced proficiency in Microsoft Office and file management.
• Demonstrated knowledge and proficiency in grammar and spelling skills.
• Ability to effectively and professionally communicate with others verbally and in writing.
• Excellent interpersonal skills with the ability to clearly present recommendations and ideas, and to summarize complex issues.
• Skilled in operating standard office equipment such as multi-line phone system, copier, fax machine, shredder, etc.
• Ability to interpret, comprehend, and transmit complicated and detailed instructions accurately.
• Ability to accept and apply feedback.
• Regular and predictable attendance is expected.
• Demonstrates the ability to recognize priorities in organization of work flow.
• Able to perform duties independently, with a minimal need for direct supervision.

About Western Michigan University Homer Stryker M.D. School of Medicine (WMed)

We are committed to excellence and health equity through transformative medical education, high-quality, patient- and family-centered care, innovative research, and community partnerships within a welcoming, supportive, and engaging culture. Our vision is health equity for all in Southwest Michigan through innovation in the practice and study of medicine.

The medical school is a collaboration of Western Michigan University and Kalamazoo's two teaching health systems, Beacon and Bronson Healthcare. The medical school is a private nonprofit corporation supported by private gifts, clinical revenues, research activities, tuition, and endowment income. WMed is the recipient of a $100 million foundational gift and the Empowering Futures Gift, a philanthropic commitment of $300 million to support the mission of the medical school. WMed contributes to the economic vitality of Southwest Michigan through the services we provide, as well as the creation of 1,600 new jobs, with an estimated annual economic impact of $353 million in Kalamazoo and Calhoun counties.

WMed is fully accredited by the Liaison Committee on Medical Education and the Higher Learning Commission. The medical school offers a comprehensive, innovative four-year Doctor of Medicine degree program as well as a Master of Science degree program in Biomedical Sciences. We train physicians in 10 residencies and four fellowships accredited by the Accreditation Council for Graduate Medical Education. To support our educational mission, we have Joint Accreditation for interprofessional continuing education, which incorporates accreditation by the Accreditation Council for Continuing Medical Education.

WMed Health is the clinical practice of the medical school with more than 300 providers offering comprehensive primary care and specialty services in several locations throughout the Kalamazoo and Battle Creek areas. Faculty in the Department of Pathology serve as the Office of the Medical Examiner for counties throughout Michigan and northern Indiana.

The W.E. Upjohn M.D. Campus located in downtown Kalamazoo serves as the primary educational facility with student study and social spaces, team-based learning halls, faculty and administrative offices, a state-of-the-art Simulation Center accredited by the Society for Simulation in Healthcare, basic science research labs, as well as toxicology and forensic pathology labs.

WMed builds upon Kalamazoo's century-long foundation of drug discovery and medical device development with a strategic investment in clinical, laboratory, community, and educational research. The Center for Immunobiology, Center for Clinical Research, Research Histology Lab, Innovation Center, and Human Research Protection Program contribute to the medical school's advancement of knowledge through innovation and discovery.

Equal Employment Opportunity Employer in compliance with applicable State and Federal law.