Credentialing Specialist

About the role

MyCHN is seeking an experienced Credentialing Specialist who is organized, analytical, detail‑oriented, and ready to take ownership of provider credentialing from start to finish. This role goes beyond paperwork processing, ensuring physicians, advanced practice providers, dentists, behavioral health professionals, pharmacists, and other healthcare professionals are properly credentialed, privileged, and enrolled so they can focus on patient care.

Responsibilities

• Manage initial credentialing and recredentialing from initiation through completion.
• Perform primary source verification and maintain accurate, audit‑ready credentialing files.
• Complete and monitor NPDB queries, exclusion screenings, licenses, certifications, DEA registrations, and other expirable credentials.
• Support CAQH, NPPES, Medicare, Medicaid, and commercial payer enrollment.
• Coordinate privileging documentation and provider enrollment activities.
• Identify missing information, discrepancies, enrollment barriers, and potential compliance risks.
• Track credentialing deadlines and help prevent delays that could affect provider start dates or payer participation.
• Partner with providers, HR, Operations, Revenue Cycle, Compliance, and clinical leadership to resolve credentialing issues.
• Support credentialing activities for new clinics, acquisitions, and organizational growth.
• Serve as the primary support personnel to the Credentialing Manager, helping maintain workflow and critical deadlines when needed.

Qualifications

• High school diploma or equivalent (required).
• 3 to 5 years of healthcare credentialing, provider enrollment, privileging, or medical staff services experience.
• Experience independently managing credentialing files from start to finish.
• Working knowledge of CAQH, NPDB, NPPES, Medicare, Medicaid, OIG screening, and payer enrollment.
• Strong attention to detail, organization, critical thinking, and problem‑solving skills.
• Strong written and verbal communication skills.
• Ability to manage multiple priorities and deadlines in a fast‑paced environment.
• Proficiency with Microsoft Office and electronic credentialing/database systems.

Preferred qualifications

• Experience in an FQHC, community health center, hospital, medical group, or multi‑site healthcare organization.
• CPCS certification through NAMSS is a plus.

Why MyCHN?

MyCHN is growing, and credentialing plays a critical role in that growth. In this position you will have the opportunity to strengthen your expertise, solve meaningful operational challenges, support new providers and locations, improve credentialing processes, and become a trusted resource across the organization. Your accuracy, judgment, initiative, and expertise truly matter.