Credentialing Specialist

A company is looking for a Credentialing Specialist to manage provider credentialing and enrollment processes.

Key Responsibilities

Lead and manage the credentialing and contracting process for Medicare, Medicaid, and Medicare Advantage payers

Monitor payer enrollment timelines to support market launches and state expansions

Maintain credentialing files and documentation in compliance with relevant standards

Required Qualifications

3-5+ years of experience in healthcare credentialing and payer enrollment, preferably with Medicare plans

Strong knowledge of regulatory and accreditation requirements (CMS, NCQA, URAC)

Familiarity with credentialing platforms such as CAQH, PECOS, and NPPES

Experience using credentialing software or provider management tools

Bonus : Experience in a multi-state or fast-growth healthcare company