Credentialing Specialist

Key Responsibilities

• Manage initial credentialing, recredentialing, demographic updates, and payer enrollment for providers across multiple states (AZ & NV)
• Monitor and track expiring licenses, DEA registrations, board certifications, malpractice insurance, and all other time-sensitive documents
• Maintain and update provider data in CAQH, PECOS, NPPES, and payer portals to ensure accuracy and compliance
• Track and follow up on all credentialing and enrollment submissions weekly to ensure timely approvals
• Support provider onboarding including new state licensure and payer network participation
• Respond to health plan and payer inquiries, resolving issues and missing documents
• Cook with internal departments (billing/operations) to communicate credentialing status updates and changes impacting claims or scheduling

Qualifications

• Minimum 2+ years of healthcare credentialing or provider enrollment experience
• High level of professionalism with excellent written and verbal communication skills
• Strong working knowledge of CAQH, PECOS, NPPES
• Proficiency in Microsoft Excel (tracking, reporting, data management) and Microsoft Word
• Able to manage high-volume workflows, prioritize effectively, and meet deadlines in a fast-paced environment
• Exceptional attention to detail, organization, and time management