Credentialing Specialist - Full Time - Germantown, TN

Job Title: Credentialing Specialist

About Us

At West Cancer Center, we are committed to providing exceptional, patient-centered cancer care through collaboration, innovation, and operational excellence. Our Credentialing team plays a critical role in ensuring our providers are properly credentialed, licensed, and enrolled so they can deliver the highest quality care to our patients.

Position Overview

The Credentialing Specialist is responsible for maintaining active credentialing status for all providers by completing initial and ongoing credentialing, privileging, licensing, and enrollment requirements for hospitals, surgery centers, and commercial and government payers. This role maintains provider information across multiple credentialing databases, manages state licensure and DEA renewals, coordinates provider enrollments, and ensures compliance with regulatory and organizational requirements while maintaining the confidentiality of provider information.

Key Responsibilities

Maintain current and accurate provider information in external credentialing databases and the MD-Staff credentialing system, including CAQH Universal Data Source

Complete provider credentialing and recredentialing applications, monitor application status, and follow up on outstanding items

Generate MD-App portals for new providers, assist providers with portal-related questions, verify application accuracy, and upload information into the MD-Staff credentialing system

Complete and submit initial Tennessee, Mississippi, and Arkansas medical license applications and required supporting documentation

Monitor expiration dates for state medical licenses, DEA registrations, life support certifications, and board certifications to ensure timely renewals

Maintain current copies of state licenses, board certifications, DEA certificates, malpractice coverage, protocols for allied health providers, and other required credentialing documents

Manage MD-Staff workflows, application progress, and checklist completion

Coordinate provider enrollment and status changes with the group's malpractice carrier (SVMIC)

Provide all required documentation to SVMIC to facilitate timely provider enrollment

Ensure physicians complete annual SVMIC CME risk management requirements

Assist the Finance Department with questions related to SVMIC statements

Maintain knowledge of current payer and agency credentialing requirements

Monitor health plan enrollment processes using MD-Staff workflows and checklists

Ensure practice location information remains current with health plans, agencies, and other credentialing entities

Process applications for hospital appointments and reappointments

Audit health plan directories to ensure accurate provider information

Create, schedule, and generate ad hoc queries and reports within the MD-Staff system for credentialing and enrollment requests

Monitor credentialing email communications and respond professionally to providers, outside entities, leadership, and staff

Collaborate with the Revenue Cycle team and billing staff to resolve credentialing-related denials and authorization issues

Work collaboratively with peers, management, other West Cancer Center departments, hospitals, insurance companies, and malpractice carriers

Coordinate with the EMR team to obtain provider case logs for hospital reappointments

Provide credentialing and privileging verifications

Maintain confidentiality of provider information

Complete urgent credentialing-related projects as assigned

Perform all other duties as assigned

Qualifications

Education & Experience

Required:

High school diploma or GED

Minimum of three (3) years of experience in a medical practice business office

Ability to organize and prioritize work while managing multiple priorities

Excellent verbal and written communication skills, including letters, memos, and email correspondence

Excellent attention to detail

Ability to research and analyze information

Ability to work independently with minimal supervision

Ability to establish and maintain effective working relationships with providers, leadership, staff, and external organizations

Proficiency in Microsoft Office applications, including Word, Excel, and Access, as well as internet-based resources

Preferred:

Three (3) or more years of credentialing experience

Work Environment & Physical Demands

Typical office environment

Frequent use of computers and credentialing software systems

Ability to sit, stand, walk, and use hands and wrists for extended periods

Ability to communicate effectively in person, by telephone, and in writing

Ability to organize, review, and maintain detailed documentation with a high degree of accuracy

Why West Cancer Center is a Great Place to Work

Meaningful Impact: Play a direct role in supporting patients through one of the most challenging times of their lives.

Collaborative Culture: Work alongside a multidisciplinary team of dedicated professionals committed to improving cancer care.

Professional Development: Benefit from ongoing training, educational resources, and growth opportunities.

Mission-Driven Environment: Be part of an organization guided by compassion, integrity, and innovation.

No nights, weekends, or holidays. Comprehensive benefits package.

Join Us

If you are a highly organized professional with experience in provider credentialing, licensing, and enrollment, and you enjoy working in a collaborative healthcare environment, we encourage you to apply for the Credentialing Specialist position at West Cancer Center.