Credentialing Specialist – Facility

🔥 14 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

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Curana Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

🤝 B2B

⚕️ Healthcare Insurance

Healthcare • B2B • Healthcare Insurance

Curana Health is a healthcare provider focused on senior primary care and on-site clinical services in skilled nursing and senior living communities. The company partners with operators, payors, and Medicare Advantage plans to implement value-based care models, offering physician-led care teams, medical director services, care coordination (including RPM and APCM), behavioral health, and palliative care. Curana emphasizes reducing hospital readmissions, falls, and polypharmacy while improving resident satisfaction through integrated, community-based care supported by technology and payor partnerships.

📋 Description

• Review facility credentialing applications for accuracy and completeness based on applicable facility and specialty requirements • Complete primary source verification and required reviews, including license, CMS Certification Number (CCN), DEA, National Practitioner Data Bank (NPDB), accreditation, and other facility credentialing reviews • Communicate with facilities to clarify questions, resolve discrepancies, and obtain missing application information • Enter, update, and maintain accurate facility information in credentialing systems • Request and follow up on facility recredentialing applications within established timelines and internal guidelines • Monitor expiration dates of facility licenses, DEA certificates, accreditations, and other required documentation • Ensure facilities continue to meet regulatory, compliance, and health plan credentialing standards • Prepare and present monthly summary reports to the Credentialing Committee • Review federal and state sanctions and exclusions reports • Generate and distribute credentialing reports to internal teams • Prepare and send approval notices, requests for additional information, and termination notices as directed by the Credentialing Committee • Provide credentialing support to the contracting department and communicate facility credentialing status updates • Manage a high-volume workload, prioritize assignments, maintain accuracy, and complete activities within required timelines

🎯 Requirements

• High school diploma or equivalent required • Previous facility credentialing experience preferred, particularly experience supporting health plan credentialing requirements • Experience reviewing accreditation, regulatory, and compliance requirements for healthcare facilities preferred • Familiarity with NCQA, CMS, or other health plan credentialing standards preferred • Additional healthcare credentialing experience or certification is a plus • Strong attention to detail and ability to maintain accuracy while managing a high-volume workload • Familiarity with facility credentialing concepts and primary source verification processes, including license, CCN, DEA, NPDB, accreditation, and other required facility reviews • Strong organizational and time-management skills • Ability to manage multiple priorities and meet production expectations in a fast-paced environment • Tech-savvy and comfortable learning new systems and technology quickly • Proficiency in Microsoft Excel and Word • Ability to work independently and remain focused and productive in a remote environment • Strong verbal and written communication skills • Ability to handle confidential information appropriately • Flexible, collaborative, and comfortable working with minimal supervision • Comfortable working across multiple screens, databases, and systems throughout the day • Experience with facility accreditation, regulatory, and compliance reviews preferred • Knowledge of NCQA, CMS, and health plan credentialing standards preferred • Experience using credentialing databases or software platforms preferred • Dedicated, professional workspace free from distractions and background noise • Ability to regularly be on camera for meetings, training sessions, and team collaboration • Ability to learn new technology quickly • Basic understanding of facility credentialing and primary source verification processes strongly preferred • Must be legally authorized to work without visa sponsorship; the company is unable to provide sponsorship for a visa

🏖️ Benefits

• Company-provided necessary equipment, including dual monitors • Training provided on the company’s credentialing platform • Remote work arrangement • Equal Employment Opportunity commitment