Credentialing Specialist

• Verify healthcare providers’ education, licenses, certifications, training, work history, and professional references
• Maintain accurate and up-to-date provider records for accrediting bodies, government agencies, and insurance companies
• Ensure providers hold valid, active licenses in the states where they practice
• Maintain organized records to mitigate legal, financial, and reputational risks
• Track expiration dates for licenses, certifications, DEA registrations, malpractice insurance, and other required documents
• Maintain a streamlined credentialing process for new providers, nurses, and health professionals
• Work closely with partners to resolve challenges and deliver thoughtful, timely, personalized service
• Coach, mentor, or guide team members and lead by example

Healthcare licensing specialist credentialing providers for Main Street Health’s rural value-based care

License and Credentialing Specialist

Healthcare licensing specialist credentialing providers for Main Street Health, the nation’s largest rural value-based care provider. Maintaining compliant records and active licenses while supporting provider onboarding.

• Manage initial credentialing, enrollment, and recredentialing processes for providers across commercial, Medicare, and Medicaid payers
• Prepare, submit, track, and follow up on credentialing applications through approval
• Coordinate provider onboarding activities related to payer enrollment and network participation
• Complete government payer revalidation and enrollment updates
• Maintain accurate provider records across CAQH, PECOS, NPPES, CMS, and other credentialing platforms
• Ensure provider files remain complete, current, and audit-ready
• Monitor credential expiration dates and proactively manage renewals
• Maintain credentialing documentation according to payer and regulatory requirements
• Support provider enrollment with commercial insurance plans, Medicare, and Medicaid
• Assist with payer communications and issue resolution
• Participate in fee schedule review and contract negotiations when applicable
• Track credentialing and enrollment statuses to minimize delays in provider activation
• Partner with Clinical HR, Billing, and Operations teams to resolve credentialing-related issues
• Communicate progress, risks, and timelines to managers and leadership
• Identify opportunities to improve credentialing workflows, processes, and tracking systems

Part-time Credentialing Specialist managing U.S. behavioral-health provider enrollment for telehealth organization

Credentialing Specialist – Part-time

Credentialing Specialist managing payer enrollment and recredentialing for Insight Therapy Solutions’ U.S. telehealth mental-health providers. Maintaining compliance, provider readiness, and efficient onboarding across commercial, Medicare, and Medicaid networks.

• Coordinate and manage credentialing and recredentialing processes for new and existing NCPS clinicians across internal and external affiliations
• Communicate with providers, hospitals, Medical Staff Offices, credentialing bodies, and other stakeholders
• Obtain, prepopulate, review, verify, submit, and track credentialing applications and supporting documentation
• Support provider onboarding through intake, document collection, milestone tracking, orientation readiness, and start-date preparedness
• Maintain accurate provider records, credentialing files, licenses, certifications, education, training, and professional references in electronic databases and other systems
• Monitor expiring credentials and privileges, notify providers, and follow up on timely renewals
• Process credentialing fees as applicable
• Resolve credentialing issues and discrepancies with providers and hospitals
• Complete credentialing tasks within timelines and proactively communicate progress and issues
• Provide regular updates to leadership and maintain high-quality, accurate outputs
• Develop and maintain relationships with providers, affiliate organizations, Medical Staff Offices, hospitals, and regulatory bodies
• Provide support, guidance, training, and answers to questions about credentialing and privileging
• Participate in quality improvement activities, analyze data, identify improvements, and implement process improvements
• Ensure NCPS providers are credentialed, recredentialed, and, where applicable, privileged at all locations where services are rendered
• Partner with practice leadership, operations, TM&E, Medical Staff Offices, and affiliate contacts to resolve onboarding and credentialing readiness issues
• Support MSO and telehealth credentialing readiness activities; payer enrollment functions are excluded unless specifically assigned

Credentialing Specialist coordinating provider onboarding for Miami children's healthcare system

Credentialing Specialist – Full Time, Day Shift

Credentialing Specialist coordinating provider onboarding, credentialing, and privileging for Nicklaus Children's Health System. Maintaining compliant provider records and readiness across hospitals, telehealth, and affiliates.

• Coordinate the credentialing and re-credentialing process for providers at participating facilities in the assigned region
• Follow Credentialing Department protocols and guidelines
• Follow verbal and written instructions from Credentialing Leadership
• Prepare reports and case logs to verify providers and staff meet facility and federal regulatory guidelines under Joint Commission standards
• Maintain and organize credential files for clinical staff, including CME, COI, immunizations, education, vendor platform, and compliance documents
• Use credentialing software and electronic platforms to track applications and update hospital affiliations and vendor-platform information
• Maintain credentialing calendars to ensure timely renewals of supporting credentials
• Interact with team members, clients, and stakeholders through various communication channels
• Manage deadlines, changing priorities, and productivity in office and remote work environments

Credentialing Specialist managing healthcare provider compliance for neurotechnologist staff

Credentialing Specialist managing hospital credentialing and compliance for neurotechnologist staff. Maintaining provider files, regulatory reports, software records, and renewal calendars.

• Manage full-cycle provider credentialing and recredentialing processes in compliance with CMS, NCQA, and state regulatory requirements
• Oversee medical payer enrollment activities, ensuring timely and accurate submission of applications to commercial payers and government entities (e.g., Medicare)
• Complete and manage PECOS and CMS 855i enrollments and updates
• Partner with providers to maintain and update CAQH profiles to ensure accuracy and attestation compliance
• Maintain and track provider records in credentialing databases, ensuring data integrity, accuracy, and confidentiality
• Track and manage active licenses and expiration dates via Modio for:
• Physicians and Advanced Practice Providers
• Registered Nurses (RNs)
• Licensed Vocational Nurses (LVNs)
• Licensed Practical Nurses (LPNs)
• Proactively monitor expirations and coordinate renewals via Modio to ensure uninterrupted compliance and ability to practice
• Maintain working knowledge of all 50-state licensure and practice requirements impacting telehealth delivery
• Research and interpret state-specific regulations, including:
• Nurse Practitioner collaborative/supervisory agreement requirements
• Scope of practice variations by state
• Establish and maintain processes to ensure compliance with varying state laws and regulatory updates
• Coordinate and manage collaborative agreements in accordance with state-specific requirements
• Monitor credentialing status and proactively resolve issues or delays with payers and regulatory agencies
• Conduct thorough review of credentialing applications in alignment with NCQA and accreditation standards
• Maintain provider data across platforms including CAQH, NPPES, PECOS, and payer portals
• Maintain comprehensive databases of provider information, ensuring accuracy and confidentiality
• Handle sensitive information with strict adherence to HIPAA and healthcare privacy standards
• Collaborate cross-functionally with recruiting, operations, and compliance teams to ensure timely onboarding

Licensing & Credentialing Specialist managing provider credentialing at CareTalk Health

Licensing & Credentialing Specialist

Licensing & Credentialing Specialist responsible for managing provider credentialing at CareTalk Health. Ensuring compliance with CMS, NCQA, and state regulatory requirements for telehealth.

• As a Credentialing Specialist for UnisLink, you will be responsible for the collection and input of all providers demographic information onto applications or payer systems
• Collaborate with various departments to gather necessary documentation, conduct thorough credential reviews, and maintain accurate databases of provider credentials
• Processing initial credential applications, re-credentialing applications, and privileging requests efficiently and accurately
• Process provider applications and re-applications, initial mailing, review and loading into the database tracking system ensuring high quality standards are maintained
• Renew medical licensure, hospital privileges and board certifications, DEA registrations and any other required credentialing documents for provider
• Prepare weekly and monthly updates as requested
• Utilize critical thinking skills to reconcile errors/updates in a timely manner
• Provide application and technical support to other team members and clients
• Develop and maintain documentation that assures the credentialing processes are complete and accurate
• Conduct professional oral and written communications with Client’s staff, facility staff, payor sources and clients as needed
• Comply with all state and federal billing rules and regulations including CMS, FDCPA, HIPAA, etc.
• Participate in identifying problems and suggesting solutions.
• Promote Unislink’s core values of Respect, Integrity, Customer Focus, and Continuous Improvement.

Credentialing Specialist managing provider demographic information for UnisLink

RCM Credentialing Specialist / Payor Enrollment Specialist

Credentialing Specialist responsible for maintaining provider credentials and ensuring compliance for UnisLink. Collaborating with departments to streamline credentialing processes and documentation.

• Managing credentialing, recredentialing, and licensure process for clinical staff with health insurance plans, certification boards and other agencies
• Ensuring compliance with various state, federal and payer requirements
• Responsible for pre-application intake, monitoring, application submission and follow up
• Maintaining an efficient and compliant on-boarding process
• Inputing/Updating provider credential databases CAQH and NPPES
• Ongoing monitoring of clinical staff’s credentials to ensure licenses and certifications are current and active
• Working closely with internal departments to exchange provider information and follow up on inconsistencies
• Assisting with other miscellaneous duties in the Revenue and Contracting department

Credentialing Specialist for Kyo managing ABA therapy staff processes

Credentialing Specialist at Kyo empowering children with autism through ABA therapy. Managing credentialing, compliance, and staff onboarding for clinical teams across multiple states.

• Take charge of the overall strategy to cut down on insurance denials and write-offs from payers
• Identify, analyze, and prioritize root causes of denials and non-payment across modalities, payers, and sites
• Design and implement systematic solutions to prevent recurrence
• Identify denial trends and turn them into actionable operational SOP’s
• Conduct follow up with payers and insurance companies to resolve claim denials and payment discrepancies
• Investigate and resolve issues causing delays in payment or reimbursement, ensuring accurate claims processing
• Assist in the identification of recurring denial patterns and recommend process improvement to reduce AR delays
• Monitor and track outstanding accounts receivable (AR)
• Collect, verify, and maintain facility/provider credentials
• Prepare and submit initial and re-credentialing applications in accordance with organizational, payor, and regulatory requirements
• Maintain accurate and complete electronic credentialing files
• Track credential expiration dates and proactively manage renewals to prevent lapses
• Complete and submit provider enrollment applications for Medicare, Medicaid, and commercial payors
• Manage enrollments using CAQH, PECOS, NPPES, and payor-specific portals
• Conduct regular follow-ups with payors to resolve delays, missing documentation, or application deficiencies
• Confirm provider participation status and effective dates with each payor
• Maintain up to date fee schedules
• Update payors with changes to provider demographics, locations, group affiliations, and tax information
• Ensure ongoing compliance with federal, state, and payor requirements
• Maintain documentation for audits and internal reviews
• Partner with billing, revenue cycle, and leadership teams to resolve credentialing- or enrollment-related claim issues

Credentialing Specialist ensuring provider enrollment and denial management for a healthcare company

Credentialing Specialist responsible for ensuring provider enrollment and cut down on insurance denials. Managing healthcare provider credentials and compliance in a fully remote environment.

• Review and screen initial and reappointment credentialing applications for completeness, accuracy, and compliance.
• Conduct primary source verification, validate documents, and ensure accuracy of credentialing elements.
• Identify, analyze, and resolve discrepancies that could impact credentialing and enrollment.
• Maintain knowledge of current health plan and agency requirements for credentialing providers.
• Track license and certification expirations for timely renewals.

Credentialing Specialist ensuring accurate provider credentialing at One GI®

Credentialing Specialist reviewing and processing provider credentialing applications at One GI®. Ensuring compliance and supporting patient care through accurate credentialing.

• The Credentialing & Enrollments Specialist is responsible for managing the credentialing, payer enrollment, and provider onboarding processes for the practice’s physicians and advanced practice providers.
• This role ensures providers are credentialed, enrolled, and maintained with commercial and government payers in a timely and accurate manner to support uninterrupted billing and patient care operations.
• The specialist maintains provider records, monitors credentialing deadlines, coordinates with payers and providers, and serves as a key resource for credentialing and insurance operations.
• This position requires strong organizational skills, attention to detail, and the ability to manage multiple deadlines in a fast-paced healthcare environment.
• This role is non-exempt (hourly) and full-time, 40 hours per week, Monday through Friday. Occasional overtime may be required to meet credentialing deadlines or business needs.

Credentialing Specialist managing provider enrollment processes for allergy and asthma practice

Credentialing and Enrollments Specialist

Credentialing Specialist managing the credentialing, payer enrollment, and onboarding processes for physicians and advanced practice providers in allergy and asthma care. Supporting billing and patient care operations in a fast-paced healthcare environment.

• Manage the end-to-end privileging and credentialing process for locum tenens physicians and advanced practice providers, ensuring compliance with client facility and Aya Locums requirements.
• Review provider applications, CVs, and supporting documentation for completeness, accuracy, and potential privileging risks.
• Prepare, submit, and track hospital privileging applications, proactively driving files to approval while meeting targeted start dates.
• Partner with providers, medical staff offices, clients, and internal teams to obtain required documentation and resolve outstanding items.
• Conduct and review primary source verifications and compliance requirements, including licensure, board certification, malpractice, and exclusion screenings.
• Monitor expiring licenses, certifications, privileges, and other time-sensitive documents to ensure ongoing compliance.
• Facilitates provider payer enrollment for clients by coordinating enrollment activities, monitoring application progress, and supporting timely payer approvals.
• Maintain accurate provider records and documentation within credentialing and compliance systems.
• Identify, troubleshoot, and escalate complex privileging issues while delivering exceptional customer service to internal and external stakeholders.

Privileging and Credentialing Specialist managing processes for locum tenens physicians

Senior Privileging and Credentialing Specialist

Privileging and Credentialing Specialist managing the end-to-end privileging process for locum tenens physicians. Ensuring compliance with client facility requirements and maintaining accurate provider records.

• Process and prepare hospital medical staff privilege applications
• Examine, research, enter data, and gather required clinician documentation to support the credentialing process
• Complete credentialing and reappointment applications, monitor progress, and follow up to meet critical deadlines
• Obtain and verify documentation including medical education, residency, fellowship, NPDB, work history, and peer references
• Track hospital credentialing committee, Medical Executive Committee, and Board meeting dates to ensure timely approvals
• Maintain consistent communication with clinicians throughout each stage of the credentialing process
• Maintain and ensure accuracy of electronic clinician credentialing files
• Track medical licensure, DEA certification, malpractice coverage, and required renewals
• Enroll clinicians in NPDB Continuous Query
• Update internal databases (CRM, SharePoint, and other systems) to maintain current practitioner and facility data
• Coordinate hospital orientation scheduling and communicate hospital training requirements
• Participate in internal matrix and implementation calls to provide credentialing updates
• Collaborate with internal teams, including Payor Enrollment, to support documentation and compliance needs

Credentialing Specialist managing clinician credentialing processes at OBHG

Credentialing Specialist managing all aspects of the credentialing and reappointment process for clinicians. Join OBHG, the nation’s largest dedicated provider of customized obstetric hospitalist programs.

• Manage the credentialing and recredentialing process for approximately 132 providers across 12 healthcare facilities.
• Verify provider licensure, certifications, education, work history, malpractice coverage, and other required documentation.
• Prepare and submit credentialing, recredentialing, payer enrollment, and hospital privilege applications.
• Maintain accurate provider records and credentialing databases.
• Monitor expiration dates and coordinate timely renewals to maintain compliance.
• Communicate with providers, payers, and facility administrators to resolve credentialing issues and obtain required documentation.
• Ensure compliance with NCQA, CMS, Joint Commission, payer, and organizational standards.
• Generate reports and maintain organized workflows to support credentialing operations.

Credentialing Specialist managing provider credentialing across multiple healthcare facilities

Medical Credentialing Specialist

Credentialing Specialist managing provider credentialing for healthcare organizations. Responsible for verifying licenses, certifications and maintaining compliance documentation across multiple facilities.

• Execute licensure and credentialing processes for new and existing providers
• Source and maintain up-to-date information regarding licensing and credentialing requirements
• Report licensure and credentialing expiration dates to providers and Field Operations Management Team
• Work closely with the enrollment team to ensure proper processing of Provider credentials

Credentialing Specialist processing provider licenses and documents at TAG

Credentialing Specialist ensuring licensure and credentialing processes for providers at The Aspen Group. Collaborating with various teams to maintain compliance and manage credentialing documentation.

• Execute licensure and credentialing processes for new and existing providers
• Obtain or request required documentation from various third-party sources
• Regular communication with appropriate state board representatives and the Field Management Team
• Source and maintain up-to-date information regarding all new and existing state and federal requirements
• Report licensure and credentialing expiration dates and renewal requirements to the providers
• Work closely with the enrollment team for proper processing of provider credentials
• Perform other clerical and administrative responsibilities as assigned

Credentialing Specialist ensuring provider licensure and credentialing documents

Credentialing Specialist in a healthcare support organization ensuring the expeditious procurement of provider licenses and documents. Collaborating with providers and the enrollment team for successful credentialing processes.

• Manage and process a high volume of credential verifications - around 2,500 per month once fully ramped - while maintaining a minimum 90% accuracy rate.
• Carefully review applications, primary source verifications, licenses, and certifications to ensure all data meets internal and regulatory standards.
• Organize your daily workflow independently to balance speed and precision, avoiding bottlenecks in onboarding and re-credentialing cycles.
• Independently manage your own credentialing queue while collaborating with the broader team to share best practices.
• Validate credentials and licenses to ensure compliance with local, state, and federal regulations.
• Partner with Credentialing Leads to process background checks and other verification tasks.
• Maintain accurate documentation for all credentialing activities.
• Report potential roadblocks, barriers, or other issues to leadership proactively.
• Support special projects and initiatives within the credentialing team.
• Perform other duties as assigned by leadership.

Credentialing Specialist verifying healthcare provider credentials for ShiftKey.

Credentialing Specialist verifying healthcare provider credentials in high-volume environment at ShiftKey. Ensuring compliance and supporting a collaborative team in a growing tech company.

• Coordinate the credentialing, recredentialing, and provider enrollment process for physicians, advanced practice providers, and allied health professionals.
• Complete, review, and submit credentialing and enrollment applications to Medicare, Medicaid, commercial insurance carriers, and managed care organizations.
• Monitor application status, follow up with payors, and resolve deficiencies to ensure timely provider enrollment.
• Verify provider credentials, including licensure, education, training, certifications, work history, malpractice coverage, and other required documentation.
• Maintain provider records in credentialing databases: MD Staff, CAQH, PECOS, NPPES, and other applicable systems, enabling tracking of credential expiration dates and maintenance of audit-ready files.
• Coordinate with providers and internal departments to obtain required documentation and respond to requests from payors for additional information.
• Research and resolve credentialing and enrollment issues affecting provider participation and reimbursement.
• Generate credentialing reports, maintain enrollment status reports, and support internal and external audits.
• Ensure compliance with federal and state regulations, accreditation standards, HIPAA, and organizational policies; communicate credentialing status updates to leadership and providers.
• Participate in process improvement initiatives.
• Willingness to work occasional nights and weekends with up to 25% of travel required.

Payor Credentialing Specialist performing credentialing and enrollment tasks for healthcare providers

Payor Credentialing Specialist

Payor Credentialing Specialist performing enrollment and credentialing duties for healthcare providers at ERC Pathlight. Collaborating with physicians and managing compliance processes in healthcare.

• Own the end-to-end payer enrollment process for new and existing providers, including initial enrollments, revalidations, demographic updates, terminations, and maintenance across commercial, Medicare, and Medicaid health plans.
• Submit, track, and proactively follow up on payer enrollment applications to ensure timely provider participation and minimize delays to patient care and revenue.
• Serve as the primary point of contact with national and local health plans, delegated credentialing organizations, CVOs, and internal stakeholders to resolve enrollment issues, missing information requests, and payer escalations.
• Maintain accurate provider data across payer portals, CAQH, credentialing systems, and internal tracking tools, ensuring consistency across all platforms.
• Support delegated credentialing activities by maintaining provider rosters, submitting required updates, monitoring compliance requirements, and preparing documentation for internal and external audits.
• Conduct routine audits of provider enrollment and credentialing files to ensure compliance with NCQA, CMS, state, and payer-specific requirements.
• Monitor key enrollment and credentialing metrics, identify risks to provider participation, and communicate status updates and timelines to leadership and cross-functional partners.
• Collaborate closely with Licensing, Practice Operations, Revenue Cycle, Recruiting, and Clinical Operations teams to ensure providers are fully credentialed, enrolled, and ready to see patients on schedule.
• Identify opportunities to improve enrollment and credentialing workflows through process standardization, documentation, automation, and operational efficiencies.
• Support provider licensing activities as needed, including coordinating new state license applications, renewals, cross-licensure efforts, and maintaining accurate licensure records.
• Monitor provider licenses, DEA and CDS registrations, board certifications, malpractice coverage, and other required credentials to ensure continuous compliance.
• Provide exceptional support to providers throughout the enrollment, credentialing, and licensing process by communicating requirements, timelines, and next steps clearly and proactively.

Licensing and Credentialing Specialist managing provider enrollments and compliance at a virtual health practice

Licensing and Credentialing Specialist

Licensing and Credentialing Specialist at Oshi Health managing payer enrollment and compliance. Collaborating with operational teams to ensure providers are credentialed and ready to deliver care.

• Adhere to NCQA guidelines.
• Audit Provider Licensure Files to NCQA guidelines.
• Pull Monthly Delegated Verification Files in accordance with NCQA.
• Knowledge of Delegated Verification Websites (ie. National Provider Data Base, etc.).
• Understanding of Initial and Re-Credential Delegated files / processing.
• Prepare and Present provider files for internal and external auditing.
• Upload and update the system and / or software with new documents.
• Request & Obtain any Licensure renewals.
• Must be able to utilize the licensure portals.
• Experience in Clearinghouse / Manual Education Verifications.
• Experience in Manual Hospital Privileges Verifications.
• Experience in Board Certification Verifications through the appropriate portals.
• Strong understanding of the differences between similar credentials (ie. Malpractice, Diplomas, etc.).
• Knowledge of what a Credentialing Committee consists of.
• Coordinate, monitor, maintain and process all internal re-credentialing to NCQA guidelines.
• Heavy Understanding of Attestation questions, actions, exclusions and explanations.
• Ability to speak effectively with providers, educators and internal departments.
• Assist offices and internal departments with credentialing issues.
• Ability to multi-task in a fast-paced environment.
• Work other projects as assigned.

Delegated Credentialing Specialist ensuring compliance with credentialing processes at Sage Dental Management

Delegated Credentialing Specialist organizing, maintaining, and verifying the credentialing process at Sage Dental Management. Working with General and Specialty Dentists to ensure compliance with legal and regulatory policies.

• This role is responsible for end-to-end provider credentialing and payer enrollment across government and commercial payers, ensuring providers are set up for success in a multi-state, virtual care environment.
• Complete and manage all aspects of initial credentialing, re-credentialing, and payer enrollment for a large network of telehealth providers across the U.S.
• Submit and track applications with government payers (Medicare, Medicaid, VA, Tricare) and commercial/private payers to ensure active participation status.
• Lead and mentor credentialing staff, providing training, guidance, and quality checks.
• Serve as the subject matter expert (SME) for credentialing, payer enrollment, and their connection to revenue cycle processes
• Optimize credentialing turnaround time and reduce payer enrollment delays that impact revenue
• Stay up to date on payer regulations and credentialing requirements across all states where the organization provides telehealth services
• Analyze denial trends related to credentialing/enrollment issues and implement corrective actions
• Track payer roster accuracy and manage data integrity between credentialing systems and billing systems.
• Maintain accurate provider records in credentialing systems (e.g., CAQH, payer portals, internal databases), ensuring information is current and compliant.
• Verify provider credentials including education, training, board certification, work history, malpractice history, and references.
• Ensure provider enrollment aligns with billing requirements, reducing claim denials and reimbursement delays for a streamlined Revenue Cycle Management (RCM) process
• Monitor payer rosters and enrollment timelines to proactively resolve issues that may impact revenue.
• Support the onboarding of new providers by ensuring credentialing and enrollment are completed prior to patient scheduling.
• Prepare reports on credentialing status, payer enrollment progress, and upcoming expirations for leadership and compliance purposes.
• Assist with audits, quality checks, and process improvements to ensure compliance.

Credentialing Specialist managing provider enrollment for a telehealth organization

Credentialing Specialist handling end-to-end provider credentialing and payer enrollment for telehealth at Heartbeat Health. Ensuring compliance and optimizing turnaround times for virtual care.

Credentialing Specialist jobs in United States

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License and Credentialing Specialist

Credentialing Specialist – Part-time

Credentialing Specialist – Full Time, Day Shift

Credentialing Specialist

Licensing & Credentialing Specialist

RCM Credentialing Specialist / Payor Enrollment Specialist

Credentialing Specialist

Credentialing Specialist

Credentialing Specialist

Credentialing and Enrollments Specialist

Senior Privileging and Credentialing Specialist

Credentialing Specialist

Medical Credentialing Specialist

Credentialing Specialist

Credentialing Specialist

Credentialing Specialist

Payor Credentialing Specialist

Licensing and Credentialing Specialist

Credentialing Specialist

Credentialing Specialist