HR & Credentialing Specialist

Position Summary

The Human Resources & Credentialing Specialist plays a critical role in supporting the HR functions of the organization, with a strong focus on provider credentialing, privileging, and onboarding, as well as assisting with employee relations and HRIS (Paycom) system operations. This role ensures that healthcare providers are fully credentialed and in compliance with all applicable standards while contributing to the effectiveness and efficiency of the HR department.

Essential Duties and Responsibilities

• Provider Recruitment, Credentialing & Onboarding

• Coordinate and manage the credentialing and privileging processes for all PCC medical, dental, and behavioral health providers.
• Meet with candidates to collect and verify documentation; ensure accuracy and timely submission to the CVO.
• Track and follow up with candidates and CVO to ensure all documents and verifications are completed promptly.
• Distribute, explain, and collect privileging applications; coordinate approval process with the Chief Medical Officer (CMO).
• Manage re-credentialing timelines, peer evaluations, and integration of quality standards with the Medical Director of Performance Improvement.
• Communicate credentialing and privileging status to providers, CMO, and relevant staff.
• Gather and submit necessary documentation for Medicaid, Medicare, commercial insurers, managed care plans, and hospital privileges.
• Monitor and track provider license and certification expirations; notify and assist providers with renewal processes.
• Maintain up-to-date records and ensure credentialing-related tasks in Athena are completed and monitored.
• Maintain up-to-date knowledge of Joint Commission and NCQA standards; attend trainings and conferences as needed.

Human Resource Administration Support

• Assist HR leadership with escalated employee relations issues and performance counseling documentation.
• Support investigations and maintain confidentiality and professionalism throughout the resolution process.

• Support onboarding processes by preparing and tracking I-9s, mandatory trainings, checklists, new hire orientation materials, and scheduling.
• Maintain accurate and confidential HR files and records; perform regular audits to ensure compliance.
• Provide general clerical support to the HR department and assist with new hire orientation.

• Assist with the planning and execution of special events such as employee recognition, benefits enrollment, organization-wide meetings, holiday events, and retirements.
• Help foster a positive and collaborative work environment through professional and cooperative interactions with all staff.
• Schedule exit interviews and intake and document employee relations concerns
• Complete monthly audit reporting, including RN/LPN licensing, NPDB checks, I-9 compliance, CPR certifications, Termination and new hire reporting, 340B program reporting
• Code and process HR-related invoices
• Prepare onboarding materials and support New Employee Orientation (NEO)
• Track and report compliance training completion
• Manage offboarding tasks, including Voya coordination
• Help coordinate employee events, place supply orders, and support recognition programs
• Support internal HR communications and initiatives

• Maintain a clean, organized, safe, and secure work environment.
• Perform other duties as assigned.

HRIS/Paycom System Support

• Assist with HRIS data entry, auditing, and system improvements.
• Support HR process automation and ensure accurate employee data management.

Qualifications

Education & Experience:

• Associate Degree required.
• 2-3 years of Healthcare related experience is preferred
• Minimum of 2 years' experience in provider credentialing (health center or hospital setting preferred).
• 2 years' experience working with Medicare, Medicaid, Managed Care, and commercial insurance preferred.
• Familiarity with Joint Commission and NCQA accreditation standards preferred

Skills & Abilities:

• Strong written and verbal communication skills.
• High level of professionalism, discretion, and confidentiality.
• Proficient in Microsoft Office (Outlook, Word, PowerPoint, Excel).
• Excellent organizational and time-management skills; able to handle multiple priorities.
• Strong interpersonal skills; able to build relationships at all levels of the organization.
• Ability to work independently and under pressure.

Physical Requirements

• Ability to remain stationary for approximately 50% of the time and move throughout clinic sites the other 50%.
• Frequent use of computers, printers, phones, and office equipment.
• Must be able to lift up to 10 pounds occasionally.
• Ability to travel between PCC sites and cover shifts as needed.
• This position operates in a professional office and clinical environment within a community-based healthcare organization. It may require occasional travel between multiple PCC sites.