Kansas City, MO, 64106, USA
9 days ago
Credentialing Specialist
Description We are looking for a meticulous and detail-oriented Credentialing Specialist to join a client in Kansas City, Missouri. In this role, you will oversee the credentialing and privileging processes to ensure compliance with established standards and regulations. This Contract-to-Permanent position offers an opportunity to contribute to the quality of a community-focused healthcare organization. Responsibilities: + Develops and implements centralized credentialing and privileging processes and procedures for Swope practitioners and maintains confidential credentialing files. + Prepares credentialing and privileging documents for all initial appointments and reappointments in a timely and complete manner for presentation to the Board of Directors. + Works closely with physicians, mid-levels, licensed independent practitioners and other licensed or certified practitioners and professional staff to acquire necessary materials and information for enrollment with commercial insurance plans. + Ensures compliance with HRSA, JCAHO and other grant makers or certification standards for credentialing and privileging of various practitioner types. + Maintains and/or acquires delegated credentialing as appropriate to benefit Swope Health. + Uses credentialing software proficiently and adds credentialing information to the HR associate record as necessary. + Coordinates with various departments to ensure communication of completed credentialing and privileging requirements to ensure appropriate billing for services. + Convenes monthly Credentialing Committee meetings, prepares agenda and records, and ensures the decisions of the committee are acted upon. Attends Board meetings as required. + Coordinate with the HR Talent Acquisition team on new hire credentialing and provider enrollment. + Ensure team members follow best practices and maintain service level agreements + Monitors/resolve team issues and associate concerns + Suggest or innovate on processes as deemed appropriate + Exercises confidentiality with regard to all information, results, data and other sensitive material. Requirements • Proven experience in credentialing, with knowledge of credentialing processes and standards. • Familiarity with provider and physician credentialing procedures. • Strong organizational skills and attention to detail. • Ability to manage and prioritize multiple tasks effectively. • Excellent communication and interpersonal skills for working with providers and regulatory bodies. • Proficiency in maintaining accurate and detailed documentation. • Experience with re-credentialing applications and processes. • Knowledge of standards set by accrediting organizations such as the Joint Commission. TalentMatch® Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. © 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .
Confirm your E-mail: Send Email