Credentialing Specialist

Job Summary

Managing all aspects of provider licensing and credentialing processes, the full-time Credentialing Specialist will work collaboratively to ensure compliance with health plan network participation across multiple states while optimizing revenue cycles and maintaining operational efficiency.

Key responsibilities

• Oversee new provider onboarding, maintenance, and verification across various regulatory platforms
• Manage health plan applications, contracting, and credentialing processes
• Support billing partners with effective dates and health plan-specific issues

Required qualifications

• Bachelor's degree in healthcare administration, business, or related field, or equivalent work experience
• Minimum 2 years of experience in provider onboarding
• Proficiency in health plan networks and knowledge of Medicare and Medicaid
• Strong understanding of licensing and credentialing processes
• Familiarity with HIPAA regulations and privacy standards