Credentialing Specialist - MountainView Medical Group

Credentialing Specialist - MountainView Medical Group Las Cruces, NM Job Details Full-time 1 day ago Benefits 401(k) Tuition reimbursement Loan assistance Qualifications Collaborate with healthcare professionals Document review (document control) Report writing Accreditation standards (regulatory compliance area) Vendor management Healthcare Administration Certified Provider Credentialing Specialist Mid-level Databases High school diploma or GED Data management Task prioritization Vendor relationship management Business Administration Productivity software Hospital compliance Business Associate's degree Hospital regulatory compliance Escalation handling 2 years Documentation review Communication skills Hospital experience Full Job Description As a Credentialing Specialist at MountainView Medical Group you'll join a team and be a part of a culture that's dedicated to providing top quality care to our patients. Our full-time employees enjoy a robust benefits package which may include health insurance, 401(k), licensure/certification reimbursement, tuition reimbursement, and student loan assistance for eligible roles. This position will be located onsite with our team. Job Summary The Credentialing Specialist is responsible for coordinating and processing all aspects of healthcare provider credentialing to ensure compliance with internal policies, hospital partner requirements, and regulatory standards. This role supports both initial and ongoing credentialing for assigned providers, ensuring timely privilege issuance, regulatory compliance, and accurate data management. The Specialist partners with hospital staff, third-party vendors, and insurance entities to maintain provider readiness and access. Essential Functions Collects, reviews, and verifies credentialing documentation for completeness and compliance with state, federal, and facility-specific requirements. Processes initial and recredentialing applications, including primary source verifications (PSV), privileging forms, and insurance applications. Tracks licensure, DEA, CSR, and certification renewals to ensure providers maintain active, unexpired credentials. Prepares and submits state collaborative agreements for advanced practice providers and monitors compliance. Coordinates license and credential requests with third-party vendors and monitors through issuance. Serves as liaison between providers, insurance carriers, and hospital credentialing departments to resolve issues and provide status updates. Maintains accurate provider data within credentialing databases, ensuring up-to-date records for internal and external audits. Prepares standard reports related to credentialing activities, expirables, and privileging timelines. Supports insurance enrollment and access setup in accordance with operational standards. Escalates delays or compliance concerns to leadership promptly. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications H.S. Diploma or GED required Associate Degree in Healthcare Administration, Business, or a related field preferred 2-4 years of experience in credentialing or provider enrollment required Experience supporting hospital credentialing programs or medical staff offices preferred Knowledge, Skills and Abilities Strong understanding of credentialing processes, regulatory requirements, and accreditation standards (e.g., The Joint Commission, NCQA). Familiarity with provider enrollment and privileging procedures. Excellent attention to detail and accuracy in managing credentialing data. Effective communication and customer service skills. Ability to prioritize tasks, meet deadlines, and manage multiple requests simultaneously. Proficiency in MS Office Suite and credentialing software systems (e.g., MD-Staff or similar). Ability to work independently and handle confidential information with discretion. Licenses and Certifications Certified Provider Credentialing Specialist (CPCS) preferred This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for an employer. INDCLINIC