Credentialing Specialist- 130703

Key Responsibilities

• Serve as the primary liaison between the agency and payer
• Manage provider credentialing and recredentialing processes
• Complete, track, and monitor payer enrollment applications
• Maintain accurate and up-to-date provider data
• Enroll and manage staff access in payer portals
• Ensure timely completion of attestations and revalidations
• Monitor provider licensure, certifications, and renewals
• Track and verify sanctions, exclusions, and disciplinary actions
• Monitor associate-level staff working toward full licensure
• Ensure data integrity and consistency across EHR, payer systems, and credentialing platforms
• Provide regular status updates and timelines for leadership
• Track and report on key credentialing and enrollment metrics

Skills And Competencies

• In-depth knowledge of credentialing, payer enrollment, and regulatory requirements
• Proficient in CAQH maintenance and management
• Intermediate proficiency in Excel
• Strong analytical and problem-solving skills
• Ability to develop strong collaborative working relationships
• Ability to manage multiple priorities simultaneously
• Ability to adapt quickly to changing priorities
• Highly self-motivated with strong organizational skills and attention to detail
• Exercise sound judgement, including appropriate escalation of issues
• Excellent interpersonal skills
• Strong ethics and personal/professional integrity

Preferred Experience

• Minimum 2-3 years of credentialing experience in a multi-provider environment
• CPCS- Certified Provider Credentialing Specialist preferred