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Job Title: Junior Credential Specialist

Job Description

As a Credentialing Specialist you will review initial and reappointment credentialing applications for completeness, accuracy, and regulatory compliance. You will conduct primary source verification and validate documentation to meet credentialing standards. Your role includes identifying and resolving discrepancies, gaps, or issues that may impact provider enrollment and escalating concerns when necessary. You will monitor and maintain credentialing files to ensure compliance with internal quality standards and external accreditation requirements. Additionally, you will submit provider rosters to delegated health plans, ensuring accuracy and timely follow-up, while updating provider data in the credentialing database.

Responsibilities

+ Review credentialing applications for completeness, accuracy, and regulatory compliance.

+ Conduct primary source verification and validate documentation.

+ Identify and resolve discrepancies affecting provider enrollment.

+ Monitor and maintain credentialing files for compliance.

+ Submit provider rosters to health plans accurately and on time.

+ Update provider data in credentialing database.

+ Prepare and track verification requests for high-volume application processing.

+ Collaborate with internal teams and external partners to resolve pending action items.

+ Support audit readiness and contribute to financial reporting accuracy.

+ Perform additional duties to support the accounting and finance team.

Essential Skills

+ Experience with CAQH credentialing.

+ Familiarity with credentialing software such as MDStaff and IntelliSoft.

+ Knowledge of PECOS Medicare database.

+ Experience with EPREP MD Medicaid portal/database.

+ Understanding of healthcare and customer service.

+ Proficiency in medical terminology.

Additional Skills & Qualifications

+ High School Diploma or GED required.

+ 3+ years of experience in healthcare provider credentialing and recredentialing.

+ Certified Provider Credentialing Specialist (CPCS) certification preferred or actively pursuing.

+ Proficient with CAQH and Medicare’s PECOS database.

+ Extensive experience with EMR/EHR systems and credentialing platforms.

+ Strong proficiency in Microsoft Office Suite.

+ Ability to analyze and interpret data effectively.

+ Demonstrated ability to thrive in fast-paced environments.

Work Environment

This position is on-site in Bethesda, MD, requiring attendance five days a week with a start time of either 8:00 AM or 9:00 AM. The work environment fosters an employee-centered culture that supports diversity and inclusion, promoting growth and success through an empowering management style.

Pay and Benefits

The pay range for this position is $25.00 - $28.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Bethesda,MD.

Application Deadline

This position is anticipated to close on Jul 31, 2025.

About Aston Carter:

Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing® double diamond winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email [email protected] (%[email protected]) for other accommodation options.