Credentialing Specialist

The Credentialing Specialist is responsible for all aspects of the credentialing, re-credentialing and privileging processes for all providers in Privia’s high-performance medical group. Primary Job Duties include following documented processes to ensure timely Primary Source Verification completion for initial and recredentialing, aligning with NCQA, CMS, and state requirements. Works with internal and external stakeholders to resolve complex provider credentialing issues, supports special projects requiring knowledge of delegated and non-delegated health plan requirements, and maintains up-to-date data for each provider ensuring timely renewal of licenses, certifications, COI’s etc. Maintains confidentiality of provider information.