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The specialist reviews and validates clinician credentialing documentation to ensure compliance and accuracy before onboarding. They also track quality trends and provide actionable feedback to internal and external teams to facilitate a seamless onboarding process.
The Credentialing Quality Assurance Specialist plays a critical role in ensuring cliniciancredentialing files meet client standards prior to clearance. This role may support both internaland external onboarding teams by reviewing documentation, tracking quality trends, andproviding actionable feedback. The specialist will serve as a key partner in driving accuracy,compliance, and timely file completion, ultimately supporting a seamless clinician onboardingexperience.
· Review, approve, or deny credentialing assets submitted in the TCoD system (e.g., licenses, certifications, background reports, etc.,)· Ensure deal is moved to appropriate status (PCC)· Validate accuracy and completeness of documents based on facility-specific protocols· Communicate directly with Onboarding Specialists (internal and external) with clear, concise notes and rationale for any denied documentation· Ensure timely follow-up on corrected and resubmitted documents· Monitor and review suppressed items for accuracy· Monitor and review At-Risk asset documentation to ensure process was followed appropriately· Approve Pending OK items when appropriate· Communicate audit completion to Onboarding Specialists once file reviews are finalized, ensuring timely feedback and corrective actions· Confirm deal has been marked as ready to start appropriately· Contribute to continuous improvement efforts by tracking trends in denied documentation and identifying common issues· Assist with various projects based on business needs
· Ability to type 40-50 wpm· Experience working in a customer service environment· Strong team player and ability to work with others within and outside of team· Strong computer skills· Ability to multi-task· Great organizational skills· Close attention to detail· Able to meet deadlines· Able to manage a large and increasing workload· Excellent communication and grammatical skills
· Positive attitude and friendly demeanor
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