Job Description

Position Overview

A growing healthcare organization is seeking a highly organized Provider Credentialing Specialist to take ownership of provider credentialing, payer enrollment, and compliance activities across a large and expanding provider network. This is a high-impact role for someone who can bring structure, accountability, and process improvement to an evolving credentialing function. The ideal candidate is detail-oriented, proactive, and capable of independently managing credentialing operations while ensuring providers remain compliant and enrolled with all required payers.

Key Responsibilities

• Manage provider credentialing and recredentialing processes from start to finish
• Verify provider licenses, DEA registrations, board certifications, education, work history, and malpractice coverage
• Maintain accurate credentialing files and supporting documentation
• Enroll providers with Medicare, Medicaid, and commercial insurance carriers
• Track enrollment applications and follow up with payers to ensure timely approvals
• Manage provider additions, updates, and terminations with insurance carriers
• Maintain and attest CAQH profiles and supporting documents
• Monitor expiration dates for licenses, certifications, malpractice insurance, and other credentials
• Conduct routine audits to ensure provider compliance and audit readiness
• Generate credentialing, enrollment, and expiration reports
• Serve as the primary point of contact for providers regarding credentialing and enrollment matters
• Coordinate provider onboarding activities with internal departments
• Develop and improve credentialing workflows, processes, and tracking systems
• Utilize Monday.com to manage projects, deadlines, and credentialing activities

• 2+ years of provider credentialing and payer enrollment experience preferred
• Experience credentialing providers with Medicare, Medicaid, and commercial insurance plans preferred
• Strong knowledge of CAQH, PECOS, and payer portals preferred
• Exceptional organizational skills and attention to detail
• Ability to manage multiple providers and deadlines simultaneously
• Strong follow-up, communication, and problem-solving skills
• Experience using Monday.com or similar project management software preferred
• Ability to work independently and take ownership of a growing function

• Opportunity to take ownership of the credentialing department
• Significant opportunity for growth and leadership as the organization expands
• Direct impact on provider onboarding, compliance, and operational success
• Collaborative and supportive office environment
• Medical, dental, and vision benefits
• 403(b) with employer match after eligibility period
• PTO and vacation accrual program

Experience Required

1-2 years