Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist responsible for credentialing and recredentialing client practitioners and ensuring enrollment with participating client health plans.

Key Responsibilities

• Initiate and support the practitioner application process, ensuring completeness for payor enrollment
• Accurately enter data to maintain the integrity of credentialing information in databases
• Enroll providers with client payors and monitor expiring credentials and certifications

Required Qualifications, Training, and Education

• Familiarity with payor websites and enrollment processes for various levels of licensure
• Experience in medical and professional credentialing processes and policies
• Associate's degree or equivalent combination of education and experience
• Minimum of 3 years' experience in provider credentialing in a healthcare setting
• Preferred: Certified Provider Credentialing Specialist (CPCS)