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Lead Credentialing Specialist

Role overview

Qualifications

  • High School Diploma or GED required
  • 5 years in credentialing within a healthcare setting
  • Prior administrative experience in a healthcare environment
  • Excellent communication and presentation skills

Responsibilities

  • Manage and oversee the credentialing process for healthcare providers
  • Lead and mentor a team of credentialing specialists, providing training and support
  • Conduct regular audits of credentialing files and implement best practices
  • Develop and deliver educational content for department meetings and training sessions

Key facts

Hard skills

Other skills

  • Training And Development
  • Leadership
  • Decision Making
  • Problem Solving
  • Microsoft Office
  • Organizational Skills
  • Social Skills
  • Detail Oriented
  • Customer Service
  • Communication
  • Collaboration
  • Time Management

About the company

Core Clinical Partners logo

Core Clinical Partners

Hospitals & Health Care

Core Clinical Partners, honored on the Inc. 5000 list, is a physician-founded and led practice management company focused on alignment with our partners and people. We specialize in Emergency and Hospital Medicine, offering physician services, revenue cycle management, and healthcare consulting. Our model connects hospitals, healthcare systems, physicians, and advanced practice providers to deliver high-quality, compassionate care. Supporting local groups where they need it, we build true partnerships that drive performance and elevate care standards. We go beyond traditional staffing models at Core. Our high-touch, value-driven approach aligns our clinical teams with hospital goals, optimizing operations and enhancing patient care. We combine local service with national resources, setting a new standard in healthcare partnerships.

Company details

IndustryHospitals & Health Care
Company size501 - 1000

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Job description

Description

Core Clinical Partners stands at the forefront of Emergency and Hospital Medicine, delivering unparalleled services through a model that emphasizes patient-centric care and operational excellence. Our corporate values – Genuine, Accountable, Dynamic, Respectful, and Fun – are the pillars that uphold our commitment to revolutionize healthcare delivery.

The Lead Credentialing Specialist is responsible for partnering with medical providers, hospitals, provider enrollment team, operations leaders, and other stakeholders to ensure providers are credentialed. This position will manage and oversee credentialing process for healthcare providers; lead and mentor team of credentialing specialists providing training, support, and guidance; conduct regular audits of credentialing files; identify areas for improvement in workflows and implement best practices. 

Essential Duties:

  • Serve as administrative support for Credentialing Manager 
  • Design, develop, and update training materials for the onboarding of new credentialing specialist and ongoing education for existing staff in conjunction with the credentialing manager 
  • Create and maintain a comprehensive library of educational materials, including how-to guides, training manuals, and reference documents. 
  • Conduct training for new credentialing specialist either remotely or in person 
  • Conduct regular training sessions and workshops to ensure all staff are proficient in the latest practices and protocols. 
  • Encourage knowledge sharing and best practices among staff. 
  • Develop and deliver educational content for department meetings, ensuring they are engaging and informative. 
  • Communicate regularly with staff to understand their needs and provide ongoing support. 
  • Perform other duties as assigned 

Skills, Knowledge, Abilities:

  • Knowledgeable on credentialing requirements and workflows for providers at differing client groups
  • Familiar with healthcare jargon and terminology related to credentialing
  • Excellent verbal and written communication skills
  • Excellent interpersonal and customer service skills
  • Excellent organizational skills and attention to detail
  • Work independently and exercise judgement on decision making and issue resolution
  • Navigate competing priorities and effectively work in a fast-paced environment
  • Manage information flow in a timely and accurate manner
  • Collaborate with professionals internal and external to the company and across geographic locations 
  • Identify and execute opportunities for improvement
  • Exhibit growth mindset and team-orientated behaviors
  • Proficient in Microsoft Office with ability to effectively navigate job related software for 
  • credentialing and other functions. 
  • Utilize independent judgment on determining areas of collaboration, escalation, and autonomy 
  • Strong leadership and team management skills 
  • Exceptional client relationship management abilities 
  • Proficient in using various educational technologies and platforms. 
  • Proven ability to design effective training materials and conduct engaging training sessions. 
  • Strong decision making and problem-solving skills 
  • Identify and execute opportunities for improvement 

Core Clinical Management, LLC is an equal opportunity employer and complies with ADA regulations as applicable.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Requirements

Education:

  • High School Diploma or GED required

Experience:

  • Prior administrative experience in a healthcare environment
  • 5 years in credentialing within a healthcare setting 
  • Experience with MS Outlook, Word, and Excel
  • Experience with MS Teams and credentialing software preferred
  • Excellent communication and presentation skills 

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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