Credentialing Specialist

Job Summary

To support healthcare provider operations, the part-time Credentialing Specialist will manage credentialing, recredentialing, licensing, and payer enrollment processes while ensuring compliance with regulatory requirements.

Key responsibilities:

• Accurately maintain and update provider credentialing and payer enrollment records across multiple systems
• Manage and monitor the payer enrollment and re-enrollment process to ensure timely participation with insurance plans
• Collaborate with internal teams and external stakeholders to align credentialing processes with organizational needs

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 such as Modio, VerityStream, or Cactus preferred
• Proficiency in Microsoft Office Suite and ability to navigate web-based portals
• Demonstrated ability to maintain confidentiality and comply with HIPAA regulations