Credentialing Specialist

Job Summary

To support a growing healthcare practice, the full-time Credentialing Specialist will manage the credentialing, contracting, and re-credentialing processes for healthcare providers with various insurance payors while working remotely.

Key responsibilities

• Prepare and submit credentialing applications and documentation for provider enrollment with insurance networks
• Follow up on application statuses and maintain an accurate database of provider credentials and payer statuses
• Collaborate with internal teams to communicate approvals and address denials as necessary

Required qualifications

• Minimum two years of health insurance credentialing experience preferred
• Associates degree preferred
• Proficient with Microsoft Office, including Excel, Word, and Outlook
• Prior data management/data integrity experience preferred
• Familiarity with state licensing requirements and various payer portals