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Job Title: Credentialing Specialist

Job Description

The Credentialing Specialist is responsible for ensuring the completeness, accuracy, and compliance of credentialing applications. This role involves conducting primary source verification, validating documentation, and maintaining credentialing files. The analyst will collaborate with internal teams and external partners to provide credentialing-related information, support audit readiness, and contribute to financial reporting accuracy.

Responsibilities

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

+ Conduct primary source verification and validate documentation to meet credentialing standards.

+ Identify and resolve discrepancies, gaps, or issues that may impact provider enrollment, escalating concerns when necessary.

+ Monitor and maintain credentialing files to ensure compliance with internal quality standards and external accreditation requirements.

+ Submit provider rosters to delegated health plans, ensuring accuracy and timely follow-up.

+ Update provider data in the credentialing database, ensuring precision and consistency across financial and operational records.

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

+ Collaborate with internal teams and external partners to resolve pending action items in the EHR system.

+ Support audit readiness and contribute to financial reporting accuracy through credentialing documentation.

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

Essential Skills

+ Experience in credentialing, data entry, and using CAQH, PECOS, and EPREP platforms.

+ Familiarity with credentialing software such as MDStaff and IntelliSoft.

+ Strong healthcare, customer service, and medical terminology knowledge.

+ High School Diploma or GED required.

+ 5+ years of experience in healthcare provider credentialing and recredentialing across all payer types.

+ Proficient with CAQH and Medicare’s PECOS database.

+ Extensive experience using EMR/EHR systems.

+ Strong proficiency in Microsoft Office Suite, with the ability to analyze and interpret data effectively.

Additional Skills & Qualifications

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

+ Demonstrated ability to thrive in fast-paced, evolving environments and adapt to ambiguity with innovative problem-solving.

Work Environment

The position is on-site in Bethesda, MD, five days a week with a start time of 8:00 AM or 9:00 AM. The company offers an employee-centered culture that supports diversity and inclusion, and a management style that encourages and empowers personal and professional growth.

Pay and Benefits

The pay range for this position is $30.00 - $34.00/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.