Credentialing & Compliance Specialist

Family Centers • Greenwich, CT

84d

About The Position

The Credentialing & Compliance Specialist is responsible for the ongoing management, monitoring, and verification of credentials for medical, dental, behavioral health, human service, and educational staff. This position ensures that all credentialing, privileging, and compliance processes are conducted accurately, efficiently, and in accordance with organizational, state, and federal standards. Reporting to the Director of Compliance, the incumbent is responsible for maintaining readiness for audits and accreditation reviews, and in fostering a culture of quality and accountability throughout the organization.

Requirements

• Associate’s degree required; Bachelor’s degree preferred.
• 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: Certified Provider Credentialing Specialist (CPCS) designation.

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.

Benefits

• Salary is commensurate with experience.
• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree
• Number of Employees: 251-500 employees