Credentialing Specialist

Overview

Ardent Health is a leading provider of healthcare in communities across the country. With a focus on consumer-friendly processes and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. We are driven by our purpose of caring for people: our patients, our communities and one another. Located in Brentwood, Tennessee, Ardent has earned a reputation as one of the industry’s strongest and most innovative healthcare systems. Our facilities and clinics are consistently recognized among healthcare’s best employers. We recognize each hospital and clinic is as unique as the community it serves. We strive to maintain strong community ties through advisory boards, contributions, charitable care, education and outreach. Ardent includes:

• 30 hospitals
• 280 sites of care
• 4,281 beds
• 24,000+ team members
• 8,200+ nurses
• 1,800+ aligned providers
• 5.8M annual provider encounters
• 421 medical residents

 Ardent makes considerable investments in people, technology, facilities, and communities, producing high quality care and extraordinary results. From newly constructed facilities and expanded services, to lifesaving technology and outstanding opportunities for employees, Ardent is committed to providing its hospitals and clinics the tools needed to succeed. We believe it is this mix of corporate support and local autonomy that equips our teams for success.  

Job Overview:

 

Performs full primary source verification (PSV) and file construction for initial credentialing and recredentialing across Ardent facilities and the managed care network. 

Responsibilities

• Conducts primary source verification of licensure, DEA registration, board certification, education and postgraduate training, work history, malpractice coverage and claims history, and hospital affiliations. 
• Queries the NPDB and applicable exclusion and sanctions databases (OIG, SAM, state-level lists) and document results. 
• Builds complete credentialing files in credentialing software to established standards, ensuring all elements are current, verified, and correctly documented. 
• Identifies, documents, and escalates discrepancies, gaps adverse findings, and unresolved verification issues. 
• Manages assigned expirables inventory, initiating outreach and follow-up ahead of expiration dates. 
• Supports recredentialing cycles on the required cadence. 
• Meets defined productivity and turnaround standards as determined by leadership. 
• Maintains accurate, audit-ready documentation of every verification attempt and outcome. 

Qualifications

Job Requirements:

• 1+ years of  experience with provider credentialing and primary source verification experience 
• Working knowledge of verification sources and credentialing documentation standards 
• Proficiency with credentialing software and standard office applications 

Preferred Job Requirements:

• CPCS certification, or eligibility with intent to certify 
• Experience with NCQA-accredited credentialing processes 
• Experience in a hospital, health system, CVO, or managed care setting