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

Compensation

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

We hire humans, not bullet points. Don't meet every single qualification? That's okay. We care more about who you are than what's on your CV. We're looking for people who are curious, resourceful, and ready to roll up their sleeves — especially if you're excited about building something new in healthcare. So if you think you could make an impact here, reach out to us.