Job Title: Credentialing Specialist
Job Overview:
Contemporary Staffing Solutions is seeking a Credentialing Specialist to join our client to support credentialing operations, compliance, and delegation oversight within a managed care environment. This role plays a key part in ensuring regulatory adherence and quality assurance by reviewing provider credentialing files, conducting audits, and monitoring performance against state, federal, and accreditation standards. The ideal candidate will bring auditing experience and a strong understanding of CMS and NCQA requirements to help maintain credentialing integrity across delegated entities. This is a contract-to-hire opportunity based in Philadelphia, PA, working hybrid (on-site Tuesday–Thursday).
Compensation:
$43.74/hour
Work Schedule:
Monday–Friday, 8:15 AM – 4:30 PM
Key Responsibilities of the Credentialing Specialist:
• Conduct credentialing and recredentialing audits to ensure compliance with regulatory, contractual, and accreditation standards.
• Review delegate-submitted rosters for completeness and accuracy, identifying discrepancies and ensuring corrective actions are documented and resolved.
• Prepare detailed audit reports, track and analyze findings, and present performance updates to leadership and oversight committees.
• Coordinate and support onboarding assessments for new delegated vendors, ensuring credentialing processes meet established guidelines.
• Develop and oversee corrective action plans (CAPs) while maintaining strong communication and partnership with vendors and internal teams.
• Stay current on evolving regulatory and credentialing requirements, implementing updates to maintain organizational compliance.
Qualifications and Skills for the Credentialing Specialist:
• 4+ years of experience in credentialing, auditing, or regulatory compliance within the healthcare or managed care industry.
• Associate degree in Business, Healthcare Administration, or related field preferred; equivalent experience considered.
• Hands-on knowledge of CMS, NCQA, and state/federal credentialing regulations.
• Proficiency in Microsoft Word, Excel, PowerPoint, Outlook, and Adobe Acrobat.
• Strong attention to detail with proven ability to manage multiple priorities and meet deadlines.
• Excellent written and verbal communication skills with a professional, collaborative approach.
Why Join Us?
This is an exciting opportunity to grow your expertise in healthcare compliance and credentialing within a mission-driven organization. You’ll gain exposure to complex regulatory processes, work closely with cross-functional teams, and contribute to maintaining quality and compliance excellence in a high-impact environment.
About Us:
Contemporary Staffing Solutions (CSS) is a trusted leader in providing contract, temporary, temp-to-hire, and direct hire staffing solutions. With decades of experience, we’ve grown from a staffing agency to a nationwide provider of workforce management solutions. Our niche recruitment expertise spans Accounting & Finance, Call Center & Office Support, Human Resources, Sales & Marketing, and Information Technology. Explore more about CSS and how we connect great talent with exceptional opportunities by visiting www.ContemporaryStaffing.com.
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