Provider Credentialing Specialist

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

Qualifications:

• 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