Credentialing Specialist

Job Summary

Detail-oriented and highly organized, the full-time Credentialing Specialist will coordinate provider credentialing, insurance payer enrollments, and recredentialing processes in a remote setting to support a growing healthcare organization.

Key responsibilities

• Coordinate provider and facility credentialing, recredentialing, and enrollment processes with insurance payers
• Review credentialing information for accuracy and completeness while maintaining provider profiles in the CAQH system
• Communicate with clinicians and insurance representatives to resolve credentialing discrepancies and ensure timely completion of applications

Required qualifications

• High school diploma or equivalent preferred
• Previous experience in medical office administration, healthcare credentialing, or provider enrollment preferred
• Familiarity with CAQH, NPI applications, and insurance credentialing processes preferred
• Ability to review and interpret provider credentialing records in electronic platforms
• Proficiency in Microsoft Office applications and electronic recordkeeping