Facility Credentialing Specialist

Curana Health, Inc. • Remote,

4d

About The Position

The Facility Credentialing Specialist ensures that the health plan’s provider network includes facilities that meet regulatory standards. The role supports compliance, member safety, and liability reduction by reviewing facility credentialing applications, obtaining verifications, maintaining credentialing records, and monitoring ongoing compliance. The specialist also communicates with facilities, supports the contracting department, and reports credentialing status and findings to internal teams and the Credentialing Committee.

Requirements

• High school diploma required.
• Proficient in Microsoft Excel and Word.
• Strong attention to detail and ability to maintain confidentiality.
• Flexible and team-oriented, with the ability to work with minimal supervision.
• Strong verbal and written communication skills.

Nice To Haves

• Additional certification or experience in healthcare credentialing.
• Prior experience in credentialing or a related field.
• Familiarity with credentialing databases.

Responsibilities

• Evaluate facility credentialing applications for accuracy and completeness according to specialty requirements.
• Obtain required verifications and ensure facilities meet regulatory standards.
• Communicate with facilities to clarify credentialing questions and obtain missing application information.
• Update and maintain credentialing software systems with facility information; correct data and keep files complete and current.
• Request and follow up on recredentialing applications to support timely processing and compliance with internal guidelines.
• Monitor expiration dates for licenses, DEA certificates, and other relevant documentation.
• Present monthly summary reports to the Credentialing Committee.
• Review federal and state sanctions and exclusions reports for facility compliance.
• Generate and distribute credentialing reports to internal teams.
• Prepare and send approval notices, requests for additional information, and termination notices as required by the Credentialing Committee.
• Assist the contracting department with credentialing support and provide ongoing facility credentialing status updates.

What This Job Offers

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