Credentialing Specialist - Multiple locations

Trusted Medical, PLLC

About us

Trusted Medical, PLLC is the clinical care delivery affiliate of Edera (www.edera.com). We specialize in serving Veterans by reducing wait times for them to gain access to disability screens and separation health assessments required by the Veteran Affairs (VA) to receive benefits. Help serve those who have served us by joining our growing team!

In addition to our core work with the VA, Trusted Medical holds multiple government contracts nationwide, allowing our providers to also participate in occupational health services for their applicants and employees. This includes pre-employment screenings, fitness-for-duty evaluations, and other health assessments that support a wide range of government agencies.

Position Description

This position directly supports the United States Military Entrance Processing Command (USMEPCOM) that conducts over 250,000 medical evaluations annually, serving as the critical gateway for applicants entering both the Regular and Reserve components of the Armed Forces. By joining Trusted Medical, you will play an essential role in ensuring the health and readiness of future service members-helping to strengthen military preparedness.

The candidate should have firsthand industry experience in Credentialing solutions and demonstrate deep familiarity with the application of electronic health records in that setting. They must work to resolve issues and change requests. They must be able to confidently lead discussions with diverse stakeholders, assess current-state workflows, and propose enhancements that consider both immediate needs and downstream impacts. Additionally, they should be adept at articulating changes to affected groups, integrating those insights into training content and communication strategies to support long-term success across future rollouts.

Applicants with VA and/or DoD experience are preferred, along with an active federal clearance or the ability to obtain one

Type of Employment: Full-time salaried and fully benefited position

Work Location/Travel: Must report to a Trusted Medical clinic daily (see locations below). This is not a remote/virtual position. Applicants must be free from travel restrictions to accommodate the evolving needs of the client.

Salary Range: starting at $52,123, depending on experience and location. Competitive salary/pay, potential bonuses based on individual and company performance. There are multiple factors that are considered in determining final pay for a position, including, but not limited to, relevant work experience, skills, certifications and competencies that align to the specified role, geographic location, education and certifications as well as contract provisions regarding labor categories that are specific to the position. The pay range for this position is highly competitive but dependent upon employment type (1099, contract, W2).

Role Reports to: Trusted Medical Senior Leadership

Direct Reports: This role has no direct reports

Responsibilities:

• Manage end-to-end credentialing processes including enrollment, initial credentialing, and re credentialing.
• Conduct primary source verification of credentials (licenses, DEA, board certifications, education, work history).
• Maintain accurate provider data in credentialing systems (e.g., CAQH, CredentialStream, PECOS, NPPES).
• Track expiration of licenses, credentials, malpractice insurance, CME, and renewals; manage recredentialing timelines.
• Submit credentialing/enrollment applications to payers and follow up until in network status is confirmed.
• Ensure compliance with state/federal regulations, NCQA, TJC, CMS, and accredited institutions.
• Assist in developing/improving internal credentialing policies and procedures.
• * Respond to information requests from regulatory agencies or public inquiries as required.

Knowledge and Skills Required:

• Deep knowledge of healthcare regulatory requirements, credentialing standards (NCQA, TJC, CMS), and payer credentialing rules.
• Strong attention to detail and analytical skills to review applications, detect discrepancies, and resolve credentialing issues.
• Exceptional organizational and time-management skills, able to manage high volumes independently.
• Excellent written and verbal communication skills.
• Research-savvy, able to verify documentation across diverse systems and sources.
• Flexible and adaptable to frequent travel, with no restrictions on mobility.

Education/Certification Required:

• in Health Information Management, Healthcare Administration, Business Administration, or related field required.

Preferred - Education/Certification:

• CPCS (Certified Provider Credentialing Specialist) certification from NAMSS is highly preferred.

Experience Required:

• 3+ years in healthcare credentialing or provider enrollment (specialist or coordinator roles).
• VA and/or DoD credentialing experience is strongly preferred.
• Experience ensuring compliance with regulatory standards and interacting with payers or government entities.
• Proven ability to manage credentialing data and documentation systems effectively.
• Demonstrated expertise in streamlining credentialing processes with accelerated turnaround times, enabling candidates to onboard and begin work more quickly.
• Technical Skills Required

Technical Skills:

• Proficiency in MS Office suite; advanced Excel preferred.
• Familiarity with credentialing platforms: CAQH ProView, CredentialStream, PECOS, NPPES, NPDB queries.
• Experience using healthcare compliance databases and understanding of data entry best practices.

Trusted Medical Locations:

All applicants must be US citizens and able to obtain a Public Trust clearance. Trusted Medical participates in the E-Verify program. Trusted Medical is a drug-free workplace.

Trusted Medical is an Equal Opportunity and Affirmative Action Employer. Trusted Medical prohibits discrimination against individuals based on their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other category protected by law. Trusted Medical takes affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or Veteran status.