Credentialing Specialist

Job Summary

To support a growing digital health environment, the remote contract Credentialing Specialist will manage provider credentialing, enrollment, and re-credentialing processes while ensuring compliance with regulatory standards and maintaining data integrity.

Key responsibilities

• Own end-to-end provider credentialing from intake through committee-ready files, ensuring compliance with NCQA standards
• Maintain data integrity by reconciling discrepancies and tracking licenses, certifications, and expirables for audit readiness
• Continuously improve throughput and quality by leveraging digital tools and staying current on credentialing policy changes

Required qualifications

• 2-5+ years of credentialing experience in a high-volume, fast-paced environment
• Proficiency in startup tech stack (Google Workspace, Notion, Slack) and experience with CRM/credentialing platforms
• Detail-oriented with strong organizational skills to manage a large queue of credentialing files
• Experience with digital process optimization and understanding of NCQA and CAQH
• Exceptional communication skills for coordinating with internal and external stakeholders