Credentialing and Privileging Specialist

Evara Health • Clearwater, FL

6h

About The Position

Manage end-to-end provider credentialing and re-credentialing in compliance with Evara Health policies and NCQA, HRSA, FTCA, AAAHC, and other regulatory standards.
Collect, verify, and track required documentation including licensure, board certification, DEA registration, malpractice insurance, and education records.
Conduct primary source verifications and background checks to ensure provider eligibility and compliance.
Maintain accurate credentialing files and digital databases, tracking expirations and proactively communicating renewal requirements.
Prepare credentialing reports and support Credentialing Committee meetings, including materials, documentation, and follow-up.
Serve as a liaison for internal departments, providers, hospitals, health plans, and licensing agencies regarding credentialing and enrollment matters.
Generate reports and dashboards to monitor credentialing status, expirables, and pending items.
Support audits, site visits, and accreditation reviews, ensuring documentation readiness.
Contribute to process improvements that enhance workflow efficiency, accuracy, and compliance.

Requirements

• High School Diploma or GED required; Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred.
• Minimum of 2 years of experience in provider credentialing or payer enrollment.

Responsibilities

• Manage end-to-end provider credentialing and re-credentialing in compliance with Evara Health policies and NCQA, HRSA, FTCA, AAAHC, and other regulatory standards.
• Collect, verify, and track required documentation including licensure, board certification, DEA registration, malpractice insurance, and education records.
• Conduct primary source verifications and background checks to ensure provider eligibility and compliance.
• Maintain accurate credentialing files and digital databases, tracking expirations and proactively communicating renewal requirements.
• Prepare credentialing reports and support Credentialing Committee meetings, including materials, documentation, and follow-up.
• Serve as a liaison for internal departments, providers, hospitals, health plans, and licensing agencies regarding credentialing and enrollment matters.
• Generate reports and dashboards to monitor credentialing status, expirables, and pending items.
• Support audits, site visits, and accreditation reviews, ensuring documentation readiness.
• Contribute to process improvements that enhance workflow efficiency, accuracy, and compliance.

Benefits

• Generous Time Off: Enjoy 15 days of paid time off with an option to cash out unused days.
• Holidays: Celebrate with 10 paid holidays and an additional 1 day off for your birthday.
• Wellness Perks: Enjoy a free gym membership to support your health and fitness goals.
• Work-Life Balance: Benefit from a typical Monday-Friday schedule.
• Educational Support: Take advantage of education assistance programs to further your professional development.
• Career Advancement: Numerous opportunities to advance within nursing leadership or other roles.
• Education Assistance: Up to $1,500 a year for education assistance including trainings, certifications or formal education

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED