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About the Role

Shriners Children’s is seeking a Credentialing Specialist to coordinate and organize the credentialing and privileging of physicians and advanced practice professionals. This role involves reviewing applications, maintaining confidentiality, and ensuring compliance with various regulatory bodies.

Responsibilities

• Coordinate and organize credentialing/privileging requests/modifications for SHC facilities and support providers requesting privileges at affiliate locations.
• Verify and document credentials and expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards.
• Manage and document all communication with providers and primary facilities to ensure notification of upcoming expirables.
• Keep a record of all credentialing activities in the credentialing database to ensure files reflect current status.
• Recognize, investigate, and validate discrepancies and adverse information obtained.
• Obtain and evaluate practitioner sanctions, complaints, and adverse data to ensure compliance.
• Maintain confidentiality and perform data entry, maintenance, and analysis of clinical provider information within the database per established guidelines.
• Collaborate credentialing, OPPE, FPPE, and privileging activities with SHC Medical Staff Offices to ensure timely approval processes.
• Participate in accreditation surveys and audits, including verification of appropriate drug and criminal background screenings.
• Prioritize workload to meet deadlines.
• Maintain current knowledge of accreditation standards (TJC, NCQA), state and federal regulations, and SHC medical staff bylaws, regulations, and procedural rules.

Requirements

• Experience in a healthcare setting performing regulatory credentialing.
• Experience with MD Staff or relevant credentialing database.
• Data entry skills, including the ability to navigate a translational database to enter and retrieve information.
• Competency in Microsoft Office applications.
• Certified Provider Credentialing Specialist (CPCS), Certified Professional in Medical Services Management (CPMSM) or equivalent certification. If candidate is not currently certified, CPCS will be required within 24 months of hire, or upon eligibility.

Skills

• Credentialing
• Privileging
• Data Entry
• Microsoft Office
• TJC Standards
• NCQA Standards
• Regulatory Compliance

Location

• Remote

Work Type

• Full-time

Experience Level

• Mid-level

Education Level

• Associate's Degree
• Bachelor's Degree

Salary/Compensations

• $24.16 - $36.24 per hour

About the Company

• Shriners Children’s is an organization that respects, supports, and values each other.
• Named as the 2025 best mid-sized employer by Forbes.
• Engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact.
• Fosters a learning environment that values evidenced based practice, experience, innovation, and critical thinking.
• Compassion, integrity, accountability, and resilience define them as leaders in pediatric specialty care.
• Operates 20+ hospitals, outpatient clinics, ambulatory care centers and outreach locations across the globe.
• Provides excellent care to children up to age 18 regardless of their family’s ability to pay or insurance status.