Credentialing Specialist

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Prairie Band, LLC

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2010

🏛️ Government

Government

Prairie Band, LLC is a tribal-owned business serving the Prairie Band Potawatomi Nation. This multifaceted holding company focuses on maximizing the unique sovereign status of the Nation to diversify and expand its economic portfolio. Prairie Band, LLC actively seeks investment opportunities and partnerships to foster growth in new and existing market sectors, leveraging strategic alliances with external parties.

📋 Description

• The Credentialing Specialist is responsible for coordinating and managing the credentialing, recredentialing, and privileging processes for healthcare providers supporting federal, state, tribal, and other government healthcare contracts. • This position ensures compliance with contract requirements, regulatory standards, accreditation guidelines, and organizational policies. • The Credentialing Specialist serves as the primary liaison between providers, contracting agencies, licensing boards, and internal departments to ensure providers are fully credentialed and eligible for assignment. • Maintain accurate and complete credentialing files in accordance with contract and regulatory requirements. • Monitor expiration dates and proactively obtain updated documentation before expiration. • Ensure compliance with requirements established by Indian Health Service (IHS), Department of Defense (DoD), Veterans Affairs (VA), and The Joint Commission. • Review contract-specific credentialing requirements and ensure provider files meet all standards prior to deployment. • Assist with provider onboarding and clearance processes required for federal facilities. • Conduct periodic audits of credentialing files to ensure accuracy and compliance. • Generate reports on credentialing status, upcoming expirations, and provider readiness. • Identify opportunities to improve credentialing workflows and turnaround times.

🎯 Requirements

• High School diploma or GED required. • Degree in business, or related field preferred. • Minimum of 5 years of healthcare credentialing experience credentialing government healthcare contractors. • Must have experience with the government eApp and MD App. • Must have familiarity with government agencies such as Indian Health Service (IHS), VA, or DoD. • Proficiency in Microsoft Office Suite (Excel, Word, Outlook, PowerPoint). • Strong understanding of credentialing regulations and industry standards. • Familiarity with NPDB, PECOS, CAQH, OIG, SAM, and state licensing boards. • Excellent organizational and time-management skills. • Strong attention to detail and accuracy. • Ability to manage multiple credentialing files and deadlines simultaneously. • Excellent verbal and written communication skills. • Proficiency with Microsoft Office Suite and credentialing management systems.

🏖️ Benefits

• Full Time Remote