Credentialing Specialist - Remote

As a Credentialing Specialist at Concentra, you're responsible for managing the onboarding process for healthcare providers. This includes initial credentialing and recredentialing, conducting primary source verifications, maintaining accurate clinician information in the IntelliCred database, and assisting with CAQH applications. You'll also work closely with medical advisors and the credentialing committee to resolve any issues that arise during the credentialing process.

To qualify for the Credentialing Specialist position at Concentra, candidates should ideally have a high school diploma or GED, with preferred experience in credentialing, particularly with CAQH. While having a Certified Professional Credentialing Specialist certification is advantageous, it's not mandatory. 1-2 years of direct credentialing experience, alongside proficiency in credentialing software like IntelliCred and an understanding of NCQA standards, will also set you apart.

Credentialing Specialists at Concentra utilize various tools, including IntelliCred for maintaining clinician credentialing data and monitoring provider licenses. They also engage with CAQH for initial credentialing processes and work extensively with documentation to verify credentials, ensuring all files meet established guidelines and standards.

Yes, candidates applying for the Credentialing Specialist role at Concentra typically need a minimum of 1-2 years of direct experience in the credentialing field. Experience with CAQH is preferred, as it will help in navigating the initial credentialing and recredentialing processes smoothly.

Concentra offers a comprehensive benefits package for its Credentialing Specialists, including medical, vision, and dental insurance, as well as 401(k) retirement plans with employer matching. Additional perks include paid time off, tuition reimbursement, commuter benefits, and employee discounts, making it a supportive workplace for your personal and professional growth.

In your response, outline the steps you recognize in the credentialing process, including primary source verification and the importance of adherence to standards like NCQA. Detail any specific tools you've used, such as CAQH or credentialing software like IntelliCred, and share any challenges you've faced and how you overcame them.

Discuss how you prioritize tasks based on urgency and importance, perhaps using methods like time-blocking or checklists. Share experiences when you've worked under pressure, highlighting how you maintain accuracy while meeting strict deadlines, and emphasize your commitment to quality even in high-stress situations.

In answering this question, emphasize your attention to detail and problem-solving skills. Describe a situation where you identified discrepancies, how you engaged with the involved parties to gather information, and the steps you took to resolve the issues efficiently while ensuring compliance with guidelines.

Articulate the vital role confidentiality plays in healthcare credentialing. Discuss the sensitive nature of the information you handle and how breaches can impact both providers' trust and patient safety. Highlight your understanding of policies and procedures that safeguard sensitive data.

In your reply, demonstrate your knowledge by discussing NCQA's role in setting standards for healthcare organizations. Mention specific criteria NCQA establishes for credentialing processes and your experience ensuring compliance with these standards in your previous roles.

Outline the systematic approach you follow for license monitoring, detailing any software tools you use, how often you perform checks, and how you track renewals. Share a specific example of how you proactively managed a licensing issue in the past.

Here, provide a specific example that showcases your preparation process for committee meetings. Discuss how you gathered data, organized your thoughts, and presented information confidently, and how you responded to questions or concerns raised during the meeting.

In your response, clarify that CAQH is a central database that streamlines the credentialing process for providers. Describe how you've used it for submitting and managing credentialing applications and its importance in ensuring a smooth onboarding experience.

Discuss the resources you utilize, such as professional organizations, webinars, or industry publications, to stay informed about developments in credentialing regulations. Emphasize your commitment to continuous education and adapting your practices accordingly to remain compliant.

Share your experiences collaborating with remote teams, highlighting communication tools you’ve used, and strategies you've implemented to ensure effective teamwork. Mention how you maintain productivity and connectivity despite distance and how you foster collegial relationships in a virtual environment.