Corporate Credentialing Specialist

Shriners Children's • Tampa, FL

30d • $24 - $36 • Hybrid

About The Position

The Credentialing Specialist coordinates and organizes ongoing credentialing and privileging of physicians and advanced practice professionals. Responsible for reviewing, analyzing, and follow-up of credentialing and privileging applications, maintaining strict confidentiality. Ensures compliance with federal and state agencies, organizational policies, and accrediting and regulatory agencies.

Requirements

• Experience in a healthcare setting performing regulatory credentialing required
• Experience with MD Staff or relevant credentialing database required
• Certified Provider Credentialing Specialist (CPCS), Certified Professional in Medical Services Management (CPMSM) or equivalent certification (required). If candidate is not currently certified, CPCS will be required within 24 months of hire, or upon eligibility
• Problem-solving and analytic skills.
• Written and verbal communication and organization skills.
• Ability to prioritize and maintain organization in a fast-paced environment, with conflicting deadlines.
• Must be flexible and able to adapt to an ever-changing environment in a productive manner.
• Detail-oriented
• Self-starter, innovative, resourceful, and results-oriented
• Work independently but also have a strong commitment to being a team player
• Adheres to professional confidentiality standards in accordance with legal, ethical, and hospital policies
• Data entry skills. Including the ability to navigate a translational database to enter and retrieve information.
• Must be able to demonstrate competency in Microsoft Office Applications (Excel, Access, Project, Word, PowerPoint, Outlook, etc.)

Nice To Haves

• Associates Degree (A.A.) in relevant healthcare field (highly preferred)
• Bachelor’s Degree (B.S., B.A., etc.) in relevant healthcare field (preferred)

Responsibilities

• Coordinates and organizes credentialing/privileging requests/modifications for an SHC facility and supports providers requesting privileges at affiliate locations.
• Ensures evidence of education, training, and experience to determine eligibility for requested privileges and membership.
• Verifies and documents credentials and expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards, as well as manages and documents all communication with providers and primary facilities to ensure notification of upcoming expirables.
• Keeps a record of all credentialing activities in the credentialing database to ensure files reflect current status.
• Recognizes, investigates, and validates discrepancies and adverse information obtained; obtains and evaluates practitioner sanctions, complaints, and adverse data to ensure compliance.
• Responsible for confidentiality and data entry, maintenance, and analysis of clinical provider information within database per established guidelines to ensure complete electronic credential file to support provider enrollment and delegation requirements.
• Collaborates credentialing, OPPE, FPPE, and privileging activities with SHC Medical Staff Offices to ensure timely approval process of governing bodies, participation in accreditation surveys and audits, to include verification of appropriate drug and criminal background screenings.
• Prioritizes workload to meet deadlines.
• Maintains current knowledge of accreditation standards (TJC, NCQA), state and federal regulations, as well as SHC medical staff bylaws, regulations, and procedural rules.
• Note: This is not an all-inclusive list of this job’s responsibilities. The incumbent may be required to perform other related duties and participate in special projects as assigned.

Benefits

• Named as the 2025 best mid-sized employer by Forbes
• Excellence in patient care
• Multi-disciplinary education
• Research with global impact
• Learning environment that values evidenced based practice, experience, innovation, and critical thinking
• Compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families.
• Provide excellent care to children up to age 18 regardless of their family’s ability to pay or insurance status.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree