Credentialing Specialist
We are looking for a detail-oriented Credentialing Specialist for a contract-to-hire opportunity. This Credentialing Specialist role is ideal for someone who can manage provider enrollment and credentialing activities with accuracy, discretion, and strong follow-through. The position supports timely submission of documentation, coordination across internal teams, and consistent maintenance of records and reporting.
If you have direct experience credentialing other doctors, providers, etc. rather than patients (as this is not a patient enrollment or patient credentialing role), then keep on reading!
Responsibilities:
- Prepare and submit payer enrollment documents and other required applications in both digital and paper formats with a high level of accuracy.
- Process credentialing and contracting requests by coordinating required information and ensuring materials are complete before submission.
- Partner with Operations, Legal, and Compliance teams to collect licenses, certifications, and supporting records needed for provider files.
- Maintain organized, up-to-date status tracking for assignments within company-approved systems and follow items through to completion.
- Safeguard sensitive information while updating provider and organizational records as changes occur.
- Support research efforts, compile relevant data, and help produce reports that assist with credentialing and enrollment activities.
- Contribute to special assignments and provide additional administrative support based on business needs.
- Follow established company policies, procedures, and quality standards in all daily work.
- Prior experience in healthcare credentialing, provider enrollment, or a closely related function is a firm requirement.
- Working knowledge of Medicare and Medicaid processes is preferred.
- Proficiency with Microsoft Word, Excel, Access, PowerPoint, and Outlook.
- Ability to gather information, organize documentation, and prepare accurate reports.
- Strong judgment in handling confidential information and managing sensitive records responsibly.
- Excellent written and verbal communication skills, along with strong organization, attention to detail, and the ability to manage changing priorities under deadlines.
- Familiarity with medical terminology, strong team collaboration skills, and typing speed of at least 40 words per minute.