Credentialing Specialist

🔥 12 hours ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 12%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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One GI®

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2020

🏥 Healthcare

🤝 B2B

💼 Consulting

Healthcare • B2B • Consulting

One GI® is a physician-centric management services organization (MSO) and network that supports independent gastroenterology practices. It partners with locally branded GI practices to provide operational, administrative, and clinical support aimed at improving patient experience, outcomes, and community-focused care. Headquartered in Brentwood, Tennessee, One GI emphasizes physician-led governance, practice optimization, and rapid growth across a network of independent gastroenterology providers.

📋 Description

• Review and screen initial and reappointment credentialing applications for completeness, accuracy, and compliance • Conduct primary source verification and collect and validate credentialing documents • Assess completeness of information and qualifications against credentialing standards • Identify, analyze, and resolve discrepancies, time gaps, and other issues affecting credentialing and enrollment • Convey problems to the Credentialing Manager • Maintain knowledge of current health plan and agency credentialing requirements • Track provider license and certification expirations and assist with timely renewals • Assist with license and DEA registration renewal applications where desired • Secure and maintain enrollment with contracted and newly contracted health plans • Secure and maintain facility affiliations where appropriate • Seek payer assistance regarding claims processed out of network

🎯 Requirements

• High School Diploma or equivalent required • Minimum of two (2) years focused provider credentialing or provider enrollment experience • Working knowledge of Provider Enrollment portals including CAQH, NPDB, Identity & Access Management, NPPES, PECOS, and Availity • Experience performing primary data source verifications • Specific knowledge of provider credentialing and payer enrollment process • Thorough knowledge of compliance with state and federal laws, including HIPAA • Facility Credentialing/Medical Staff Services experience preferred • Strong knowledge of credentialing processes • Attention to detail • Commitment to supporting high-quality patient care through accurate and timely provider credentialing

🏖️ Benefits

• Excellent paid time off • 401(k) plan with employer match • Education reimbursement opportunities with annual support based on employment status • Internal growth opportunities • Training and development support • Competitive health and supplemental benefits • FSA and HSA options • Employee referral bonus