Credentialing & Compliance Specialist jobs in United States
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Family Centers ยท 5 hours ago

Credentialing & Compliance Specialist

Family Centers is a private, nonprofit organization offering health, education and human service programs to children, adults and families in Fairfield County. The Credentialing & Compliance Specialist is responsible for managing and verifying credentials for various staff, ensuring compliance with standards, and maintaining readiness for audits and accreditation reviews.

ChildrenEducationHealth CareNon Profit
Hiring Manager
Joanne Derwallis, SPHR
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Responsibilities

Maintain and update credentialing files and databases for all licensed and contracted personnel in accordance with internal policies and confidentiality standards
Verify education, professional licensure, certifications, and work history through external databases, including the NPDB, OIG Exclusion List, AMA, and state licensing portals
Track and monitor expiration dates for licenses and certifications, ensuring timely renewals and compliance with regulatory requirements
Support the privileging and re-privileging process by preparing and reviewing necessary documentation in collaboration with other functions
Partner with the Director of Compliance to sustain ongoing monitoring systems and monthly audit processes
Conduct follow-up and corrective actions based on audit findings
Ensure preparedness for external audits, accreditation reviews, and regulatory inspections
Maintain current knowledge of relevant legal requirements, accreditation standards, and compliance protocols
Generate timely and accurate reports related to credentialing, verifications, and compliance activities for internal leadership and external agencies
Serve as a resource for staff and supervisors regarding credentialing requirements and compliance policies
Communicate professionally and confidentially with internal and external stakeholders

Qualification

Credentialing managementCompliance standards knowledgeDatabase managementMicrosoft Office proficiencyCPCS certificationAttention to detailOrganizational skillsTime managementWritten communicationVerbal communication

Required

Associate's degree required
Minimum of one (1) year of relevant experience in credentialing, privileging, or healthcare administration
Demonstrated knowledge of healthcare regulations, compliance standards, and accreditation requirements
Proficiency in Microsoft Office applications and database management
Proven exceptional attention to detail and accuracy with strong organizational and time management skills
Excellent written and verbal communication skills
Ability to maintain confidentiality and exercise sound judgment

Preferred

Bachelor's degree preferred
Certified Provider Credentialing Specialist (CPCS) designation

Benefits

Generous paid time off
Medical, dental, and vision coverage
Tax-free spending accounts
Disability
Life and AD&D insurance
Employee assistance and wellness programs
Pet insurance
Tuition assistance
Retirement savings

Company

Family Centers

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Family Centers is a non-profit organization that offers education, health care, and human services to children and adults.

Funding

Current Stage
Growth Stage
Total Funding
unknown
Key Investors
Exact Sciences
2024-07-17Grant

Leadership Team

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Bob Arnold
President&CEO
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Jim Vivier
Chief Operating Officer
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Company data provided by crunchbase