Position Overview:
A leading healthcare organization is seeking a highly organized and detail-oriented Provider Credentialing Specialist to manage credentialing, recredentialing, and payer enrollment. This role ensures compliance with regulatory and insurance requirements while supporting timely provider onboarding and uninterrupted reimbursement.
Responsibilities:
Manage full-cycle credentialing and recredentialing processes
Complete and submit credentialing and payer enrollment applications
Verify provider credentials (licenses, DEA, certifications, education, work history)
Maintain credentialing files and ensure documentation accuracy
Enroll providers with Medicare, Medicaid, and commercial payers
Track applications and follow up with insurance carriers
Maintain CAQH profiles and ensure timely attestations
Monitor expirations and ensure ongoing compliance
Use Monday.com to track workflows, deadlines, and onboarding
Requirements
Credentialing and payer enrollment experience preferred
Experience with Medicare, Medicaid, and commercial insurance
Proficiency in CAQH, PECOS, and payer portals
Strong organizational and multitasking skills
Ability to work independently with minimal training
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