Credentialing Specialist

A5 Healthcare (Anders Affiliate) one of one of the fastest-growing Credentialing Verification Organizations in the country is seeking a Credentialing Specialist who is motivated to learn, excited to collaborate and passionate about delivering outstanding results. This individual will have a direct impact on our firm’s mission of serving as a catalyst for those striving to achieve their highest potential. The Credentialing Specialist will be accountable for performing all the duties related to the requesting, receiving, processing, and primary source verifying applications for initial and reappointment for multiple facilities. This position will exemplify a culture of excellence, effective communication and collaboration, and customer service with CVO leadership and staff, internal and external customers and providers. Must handle, with discretion, issues that are significant, complex, multidisciplinary, sensitive, and confidential. What You’ll Do: Application management and verification activities, preliminary analysis of application and verification information, and analyzing verification information, to include identifying red flag and/or adverse information. Ability to research and analyze documents utilizing strong documentation skills with high attention to detail. Maintain timely communication with applicants and member organizations on the status of the application files and any required documents or information needed to complete the medical credentialing process. Monitoring expiring information such as, but not limited to, federal and state DEA, state professional license(s), professional liability insurance, and specialty board certification status. Timely and accurately prepare credential files for audit and submission to assigned facilities. Compliance with standard turn-a-round times. Maintain a working knowledge of relevant regulatory standards (i.e., TJC, AAAHC, DNV and NCQA), state and federal requirements and CMS. Assist with the development and implementation of credentialing and re-credentialing workflows to ensure efficient and effective alignment of processes and assist in the development or revision of credentialing related forms. Participation in special project teams as assigned. What We’re Looking For: Knowledge of credentialing software and associated applications. Experience with credentialing verification and application audit process. Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance. Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents. Ability to follow policies and procedures. May set priorities and organize work within general guidelines. Seeking assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager. Ability to communicate clearly and effectively with internal and external customers. Ability to comprehend and converse to communicate effectively assigned facilities. Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations. Ability to work collaboratively in small teams to improve the operations of immediate work groups by offering ideas, identifying issues, and respecting team members. Your Qualifications: Associate Degree preferred, High School diploma or GED required. 3-5 years related work experience required in CVO or other credentialing setting. Certified Provider Credentialing Specialist (CPCS) required. Experience with computer systems required, including web-based applications and some Microsoft Office applications which may include Outlook, Word, -Excel, and credentialing database. Applicants to the Credentialing Specialist position must be located within the Greater St. Louis, MO area. The stated pay scale reflects the range that Anders reasonably expects to pay for this position.  The actual pay rate for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and firm business practices. Salary Range $43,680 — $56,160 USD Why You’ll Love Working Here: At Anders, taking care of our employees is a top priority. Our welcoming and collaborative culture will make you feel like a part of the team from day one. From professional development opportunities to benefits that directly impact mental, physical and financial wellness, Anders offers unique incentives that enrich your life and facilitate growth, including our Work Flex program which gives you the opportunity to work at our Chesterfield office, our Downtown St. Louis office, remotely, adopt a hybrid approach or even switch between these options as you prefer. Learn more about our full benefit offerings, Work Flex program, and our Inclusion Network at our careers page: anderscpa.com/careers/working-at-anders/ All applicants for this position must be authorized to work in the United States now and in the future without requiring sponsorship. For 60 years, Anders has delivered full-service accounting, tax, audit and advisory services to growth-oriented companies, organizations and individuals. Every day, our partners and staff serve as a catalyst for those striving to achieve their highest potential and carry this mentality on to our clients and community. Ranked #75 on Accounting Today’s List of Top Accounting Firms and continually named a Top Workplace, Anders is a member firm of LEA Global, one of the largest international associations of independent accounting firms. For more information on Anders, visit anderscpa.com and follow us on Facebook, LinkedIn, and Instagram: @AndersCPA If you have questions about the data we collect and how it's used, view the Anders Privacy Policy .