Credentialing Specialist

Job Summary

Managing the credentialing and payer enrollment processes, the full-time Credentialing Specialist will ensure compliance and support uninterrupted patient care while collaborating with internal teams and external providers.

Key responsibilities:

• Accurately maintain and update provider credentialing and payer enrollment records across multiple systems
• Manage the payer enrollment and re-enrollment process to ensure timely participation with insurance plans
• Analyze credentialing files for accuracy and compliance, resolving any discrepancies or deficiencies

Required qualifications:

• 2+ years of experience in provider credentialing
• Working knowledge of payer enrollment processes for commercial and government insurance plans
• Experience with credentialing/enrollment software preferred
• Proficiency in Microsoft Office Suite and web-based portals
• Demonstrated ability to maintain confidentiality and comply with HIPAA regulations