Credentialling Specialist

About the Role

We are seeking a detail-oriented Credentialing Specialist with 3+ years of experience to join our team. This role is responsible for managing the end-to-end credentialing and re-credentialing process for providers, ensuring compliance with regulatory, payer, and accreditation standards. The ideal candidate has strong organizational skills, a keen eye for detail, and experience navigating credentialing databases and payer enrollment systems.

Key Responsibilities

• Process initial credentialing and re-credentialing applications for physicians, nurse practitioners, and other healthcare providers
• Verify provider credentials, including licenses, education, board certifications, malpractice history, and work history through primary source verification (PSV)
• Maintain accurate and up-to-date provider files in credentialing databases MD-Staff
• Coordinate with payers to complete provider enrollment and ensure timely reimbursement eligibility
• Track expiring licenses, certifications, and insurance to ensure continuous compliance
• Prepare credentialing files for committee review and present findings as needed
• Ensure compliance with NCQA, URAC, CMS, Joint Commissio