Credentialing Specialist

• Location 3901 Parkway Circle, Suite 100, Springdale, AR, 72762, United States
• Job Category Credentialing, Provider Enrollment, Healthcare Compliance
• Employee Type Non Exempt - Full Time
• Manage Others No

Behind every exceptional healthcare team is a credentialing expert ensuring providers are ready to deliver care.

As a Credentialing Specialist, you'll play a vital role in maintaining compliance, managing provider enrollment, and ensuring clinicians are credentialed accurately and efficiently. Join a team where your attention to detail directly supports quality patient care.

Highlands Oncology began in 1996 with three physicians and a desire to change the face of oncology care in our community. Dr. Malcolm Hayward, Dr. Dan Bradford, and Dr. Thad Beck knew that patients do better at home, in the community where they live and work, and where their support system is already in place. In furthering that goal, Highlands has grown with the region from a single location 26 years ago, to 6 locations in Northwest and Northcentral Arkansas today employing more than 800 diverse team members.

As Northwest Arkansas continues to grow, so must the services and providers available in the region. Highlands Oncology is committed to remaining on the cutting edge to ensure our community has access to the very best cancer care. What we have is something quite unique right here in our own backyard with a caring multidisciplinary team focused on treating patients like family.

The Credentialing Specialist, under the general direction of the Credentialing Coordinator, provides administrative, operational, and provider-facing support for Highlands Oncology Group, P.A.'s credentialing, recredentialing, privileging, enrollment, and related provider compliance processes. This position supports the Credentialing Coordinator and Credentialing and Enrollment Analyst(s) by collecting and maintaining required information and documentation, preparing and tracking applications and submissions, monitoring deadlines and outstanding requirements, performing routine verifications, maintaining credentialing systems and records, and following up with providers and other stakeholders.

The Credentialing Specialist performs assigned duties in accordance with established procedures and department direction and promptly escalates deficiencies, conflicting requirements, unusual circumstances, adverse determinations, or matters requiring interpretation or independent judgment to the Credentialing Coordinator or Credentialing and Enrollment Analyst.

• Provides administrative, operational, and provider-facing support to the Credentialing Coordinator and Credentialing and Enrollment Analyst(s) in credentialing, recredentialing, privileging, enrollment, and related provider compliance activities.
• Compiles, maintains, updates, and tracks accurate credentialing and demographic information for Highlands providers and facilities in accordance with established procedures.
• Assists with the preparation, completion, submission, and tracking of provider credentialing, recredentialing, privileging, enrollment, revalidation, and related applications and supporting documentation as assigned.
• Tracks application status, deadlines, expirations, outstanding documentation, signatures, attestations, and other requirements and performs timely follow-up to help ensure required submissions are completed by applicable deadlines.
• Proactively communicates with providers regarding outstanding credentialing, privileging, renewal, verification, and documentation requirements through approved communication methods, including in-person communication, telephone, electronic messaging, and text messaging.
• Provides hands‑on assistance to providers completing credentialing and privileging paperwork, applications, attestations, renewals, and other required submissions.
• Travels to Highlands locations and other approved locations as needed to meet with providers and assist them with completing required credentialing and privileging activities.
• Assists providers with accessing and navigating credentialing, privileging, licensing, and other required systems and resources and coordinates additional technical or departmental assistance when necessary.
• Maintains current copies of provider licenses, certifications, accreditations, DEA registrations, malpractice coverage, and other required credentialing or regulatory documentation.
• Tracks provider and applicable clinical staff…