Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist to manage the end-to-end credentialing process and ensure compliance with payor enrollment and Medicare certifications.

Key Responsibilities

• Spearhead planning and execution of new Payor credentialing applications and manage timelines and documentation
• Direct the lifecycle of Medicare certifications and ensure compliance with federal regulations
• Monitor changes in CMS PECOS and Payor credentialing requirements, communicating updates to stakeholders

Required Qualifications

• High School Diploma or equivalent required
• Prior credentialing experience preferred
• Experience in establishing and maintaining relationships with various organizational levels
• Competency in using information support systems (e.g., PECOS, Microsoft Office Suite)
• Experience in applying and maintaining pharmacy or other licenses