Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist to manage provider credentialing and enrollment processes.

Key Responsibilities

• Lead and manage the credentialing and contracting process for Medicare, Medicaid, and Medicare Advantage payers
• Monitor payer enrollment timelines to support market launches and state expansions
• Maintain credentialing files and documentation in compliance with relevant standards

Required Qualifications

• 3-5+ years of experience in healthcare credentialing and payer enrollment, preferably with Medicare plans
• Strong knowledge of regulatory and accreditation requirements (CMS, NCQA, URAC)
• Familiarity with credentialing platforms such as CAQH, PECOS, and NPPES
• Experience using credentialing software or provider management tools
• Bonus: Experience in a multi-state or fast-growth healthcare company