Credentialing Specialist

CommonSpirit Health • Lincoln, NE

66d

About The Position

As our Credentialing Specialist, you will play a pivotal role in maintaining the integrity of our medical staff database and ensuring regulatory compliance across the CommonSpirit Health system. You will be responsible for coordinating the full lifecycle of the credentialing and re-credentialing process, including initial appointments, reappointments, and the management of clinical privileges for Medical Staff and Advanced Practice Clinicians. By staying current with healthcare laws and accreditation standards—such as Joint Commission, NCQA, URAC, and CMS—you will act as a key administrator in upholding our high standards for patient safety and organizational excellence. Every day you will conduct thorough background investigations and primary source verifications to ensure all practitioner applications meet eligibility requirements. You will manage the credentialing database, generating accurate reports and queries to track expirables and application progress. Your daily workflow will involve identifying discrepancies, resolving credentialing issues, preparing comprehensive files for review, and interfacing with both internal stakeholders and external healthcare organizations to facilitate seamless communication and managed care delegated audits. To be successful in this role, you will possess strong informational research skills and the ability to interpret complex regulatory requirements with independent judgment. We are looking for a detail-oriented professional who excels at program planning and database management, with the ability to communicate effectively both orally and in writing. A High School Diploma or GED is required, along with a solid working knowledge of medical credentialing procedures and hospital operations. If you are a proactive problem-solver dedicated to maintaining the highest ethical and professional standards in medical affairs, we invite you to join our team.

Requirements

• High School Diploma or GED
• Solid working knowledge of medical credentialing procedures and hospital operations.
• Strong informational research skills.
• Ability to interpret complex regulatory requirements with independent judgment.
• Detail-oriented professional.
• Proficiency in program planning and database management.
• Ability to communicate effectively both orally and in writing.
• Proactive problem-solver.
• Dedicated to maintaining the highest ethical and professional standards in medical affairs.

Responsibilities

• Coordinating the full lifecycle of the credentialing and re-credentialing process, including initial appointments, reappointments, and the management of clinical privileges for Medical Staff and Advanced Practice Clinicians.
• Conducting thorough background investigations and primary source verifications to ensure all practitioner applications meet eligibility requirements.
• Managing the credentialing database, generating accurate reports and queries to track expirables and application progress.
• Identifying discrepancies and resolving credentialing issues.
• Preparing comprehensive files for review.
• Interfacing with both internal stakeholders and external healthcare organizations to facilitate seamless communication and managed care delegated audits.
• Staying current with healthcare laws and accreditation standards (e.g., Joint Commission, NCQA, URAC, and CMS).

What This Job Offers

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