Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist who will manage provider enrollment and credentialing workflows for dermatology practices nationwide.

Key Responsibilities

• Oversee the full lifecycle of credentialing for physicians and advanced practice providers, ensuring compliance with industry standards
• Prepare and manage payer enrollment applications and maintain accurate provider data across various platforms
• Design and implement structured workflows and processes to enhance efficiency and accuracy in credentialing operations

Required Qualifications

• 2 to 3 years of hands-on medical credentialing or payer enrollment experience
• Familiarity with CAQH, PECOS, payer portals, and credentialing software
• Strong understanding of NCQA, TJC, CMS, and standard credentialing requirements
• Proven ability to build processes in complex or unstructured environments
• Experience in maintaining accurate and audit-ready documentation