Credentialing Specialist

Job Summary

To support a growing healthcare team, the full-time Credentialing Specialist will manage provider credentialing, recredentialing, and enrollment processes while working remotely.

Key responsibilities

• Manage the initial credentialing and recredentialing processes, ensuring compliance with regulatory and payer requirements
• Prepare and monitor credentialing applications for hospitals and health plans, maintaining accurate provider records
• Respond to credentialing inquiries and collaborate with internal departments to resolve enrollment issues

Required qualifications

• Minimum of 2 years of experience in credentialing, provider enrollment, or healthcare administration
• Strong understanding of Medicare, Medicaid, and commercial payer requirements
• Familiarity with credentialing databases and provider management systems
• High school diploma or equivalent; associate or bachelor's degree in a related field preferred
• Willingness to obtain Certified Provider Credentialing Specialist (CPCS) designation