Credentialing Specialist

Anders•Chesterfield, MO

1d•$43,680 - $56,160•Hybrid

About The Position

A5 Healthcare (Anders Affiliate), a rapidly growing Credentialing Verification Organization (CVO), is seeking a motivated and collaborative Credentialing Specialist. This role is crucial to the firm's mission of empowering individuals to reach their highest potential. The Credentialing Specialist will manage and verify credentialing applications for initial appointments and reappointments across multiple facilities. Key responsibilities include data analysis, primary source verification, monitoring expiring provider documents, ensuring compliance with regulatory and accreditation standards, supporting credentialing workflows, maintaining turnaround times, and communicating effectively with internal staff, providers, and external organizations. The position demands discretion, strong documentation and analytical skills, and the ability to handle confidential and complex tasks with professionalism and excellent customer service.

Requirements

High school diploma or GED required.
1–3 years of relevant credentialing experience, preferably within a CVO or similar setting.
Proficiency with Microsoft Office applications (Word, Excel, Outlook) and web-based systems.
Strong documentation and analytical skills with high attention to detail.
Ability to interpret and apply credentialing standards and regulatory guidelines.
Excellent verbal and written communication skills.
Proven ability to organize, prioritize, and manage multiple responsibilities.
Ability to work independently and in a team-based remote environment.
Sound problem-solving and decision-making capabilities.
Commitment to confidentiality and professional ethics.
Applicants must be located within the Greater St. Louis, MO area.
Must be authorized to work in the United States now and in the future without requiring sponsorship.

Nice To Haves

Knowledge of credentialing software platforms and auditing processes preferred.

Responsibilities

Perform comprehensive application management, including requesting, receiving, processing, and verifying initial and reappointment applications.
Conduct preliminary analysis of application data and verification information to identify any red flags or adverse findings.
Monitor expiring provider data such as professional licenses, DEA registrations, board certifications, and malpractice insurance.
Communicate timely updates to providers and member organizations regarding application status and outstanding requirements.
Prepare credentialing files accurately and submit them for facility audits and approvals in accordance with turnaround standards.
Maintain working knowledge of relevant accreditation and regulatory standards (TJC, AAAHC, DNV, NCQA, and CMS).
Assist with continuous improvement of credentialing workflows, including process alignment and development of forms.
Participate in special projects and team initiatives as assigned.
Maintain credentialing documentation and records with accuracy and confidentiality.
Follow organizational policies and escalate issues beyond scope as needed.
Collaborate effectively with CVO leadership and credentialing team members.
Attend training sessions and professional development meetings to stay current with industry best practices.