Credentialing Specialist

Discover Better Health Careers with Rendr! Who We Are Rendr is the leading primary care–focused, multi-specialty medical group dedicated to serving Asian communities in New York. With 20+ clinical specialties across 100+ clinics, Rendr delivers comprehensive, culturally responsive care to approximately 200,000 patients across New York City and Nassau County. Our mission is to provide world-class, value-based healthcare with kindness to Asian communities. By combining high-quality, coordinated clinical services, advanced technology, and a deep understanding of the communities we serve, Rendr is working to improve access, patient experience, and health outcomes. Joining Rendr means becoming part of a growing, mission-driven healthcare organization with the scale and ambition to transform community-based care for Asian communities. Why Join Rendr?

• Opportunities for professional growth and development.
• Competitive salary and benefits package. (Salary is based on previous experience and years of service.)
• Join a team that values employee, embraces diversity, and is committed to making a meaningful impact within our communities.

Benefits We Offer:

• Medical, Dental, and Vision Insurance
• 401k with Company Match
• Paid Time Off
• Paid Holidays/ Floating Holiday(s)
• Commuter Benefits
• Health Savings Account/ Flexible Spending Account/ Dependent Care Account
• Annual Performance Bonus

Job Position: Credentialing Specialist

Essential Functions

• Manage the full lifecycle of provider enrollment and maintenance with commercial, Medicare, Medicaid, and managed care payers
• Prepare, submit, and track provider enrollment applications for new providers, existing provider updates, and practice acquisitions
• Monitor enrollment status and proactively follow up with health plans to ensure timely approval and participation
• Serve as the primary point of contact for payers regarding provider enrollment, demographic changes, revalidations, and participation status
• Coordinate provider onboarding activities to ensure timely enrollment and billing readiness
• Process provider updates including changes to practice locations, specialties, tax identification numbers (TINs), NPIs, and hospital affiliations
• Ensure providers are accurately linked to group contracts, billing entities, and participating networks
• Research and resolve enrollment application rejections, denials, and participation discrepancies
• Track payer revalidation requirements and ensure all required documentation is submitted timely
• Maintain accurate provider enrollment records and supporting documentation within applicable databases and software systems
• Review and update assigned provider CAQH profiles within required attestation timelines
• Monitor payer directories and rosters to ensure provider information is current and accurate
• Collaborate with Revenue Cycle Management, Practice Operations, and Human Resources to support provider onboarding, transfers, and terminations
• Assist providers, site staff, and revenue cycle teams with issues related to enrollment, credentialing, and payer participation
• Complete primary source verification and credentialing activities as required
• Track licenses, DEA registrations, board certifications, malpractice coverage, hospital affiliations, and other credentialing requirements
• Maintain working knowledge of payer enrollment and credentialing requirements, CMS regulations, and industry best practices
• Generate reports and provide status updates regarding pending enrollments, approvals, and payer turnaround times
• Participate in Health Plan meetings as needed
• Identify opportunities to improve enrollment workflows and reduce provider billing delays
• Perform other duties and special projects as requested by the Credentialing Director

Qualifications

• Bachelor's degree preferred; equivalent combination of education and experience will be considered
• 3+ years of provider enrollment, credentialing, or managed care experience within a healthcare setting
• Strong knowledge of Medicare, Medicaid, Commercial Payer, and Managed Care enrollment processes
• Experience utilizing CAQH, PECOS, NPPES, and payer enrollment portals
• Familiarity with credentialing, provider onboarding, and payer participation requirements
• Ability to manage multiple priorities and meet critical deadlines
• Excellent time management and organizational skills
• Strong interpersonal skills with the ability to work effectively with providers, clinical leadership, operations, and external payer representatives
• Strong attention to detail and problem-solving abilities
• Ability to work independently and within a fast-paced environment
• Proficiency with Microsoft Office Suite and credentialing/enrollment software systems

Rendr is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We look forward to reviewing your application and exploring the possibility of you joining our team!