Contracting & Credentialing Specialist

Your Opportunity

We're hiring a Contracting & Credentialing Specialist who will be responsible for supporting all credentialing, licensing, and payer contracting activities within the Managed Care Contracting & Credentialing Department. This role ensures MD, APRN, RPSGT, RTT profiles and facilities are appropriately credentialed and licensed (include Rx authority and autonomous practice when applicable), re-credentialed, and contracted in compliance with regulatory, payer, and organizational requirements. This is a hands-on role reporting directly to the Sr. Manager, Contracting & Credentialing, works closely with internal stakeholders, payers, and external agencies to support timely onboarding and ongoing compliance.

What You'll Do

• Coordinate end-to-end provider credentialing and re-credentialing processes with commercial and government payers, including application submission
• Prepare, submit, and track credentialing applications through CAQH and payer portals
• Support payer contracting activities, including data collection, application submission, and follow-up
• Submit and follow up on licensing activities with multi-state boards and provide update and visibility to leadership
• Maintain accurate provider credentialing files in accordance with regulatory and accreditation standards (federal, state and local regulations)
• Monitor credentialing timelines and proactively address delays or deficiencies
• Serve as a liaison between providers, internal departments, and payers regarding credentialing, licensing and contracting status
• Maintain credentialing databases and ensure data integrity across systems
• Assist with audits, reporting, and credentialing (licensing) metrics as requested
• Support licensing needs guided by the organizations growth
• Stay current on payer requirements, regulatory changes, and industry best practices
• Provide administrative and project support to the Senior Manager of Contracting & Credentialing as needed

What You Bring

• Bachelor's degree or equivalent experience preferred
• 3+ years of experience in provider credentialing, licensing and/or managed care contracting
• Sleep Clinic, Sleep device and Telehealth (multi-state) experience is a plus
• Strong working knowledge of state boards, CAQH, payer portals, and credentialing workflows
• Familiarity with ACHC, AASM, CMS, and state regulatory requirements
• Strong attention to detail, organization, and follow-up skills
• Ability to manage multiple priorities and deadlines in a fast-paced environment
• Excellent written and verbal communication skills
• Credentialing certification (CPCS or CPMSM) a plus

Our Core Values

At Sunrise Group, we keep things clear and simple ✨, value trust and collaboration 🤝, and lead with optimism and compassion 🌞. These values guide everything we do.

What We Offer

• Meaningful work that directly improves peoples' lives
• Be part of an international team across the US, France, Belgium
• Annual team offsite
• Comprehensive health benefits (medical, dental, vision)
• FREE One Medical membership
• 401(k) with company match
• 20 days PTO + 10 paid holidays + 80 hours paid sick leave
• Monthly phone and internet stipend

Pay

$60,000 - $70,000 depending on experience.