Credentialing Specialist

About the Role

A long-term contract position focused on coordinating accurate, timely credentialing documentation, maintaining provider records, and helping ensure licenses and certifications remain current.

Responsibilities

• Guide healthcare providers through initial credentialing and recredentialing submissions, ensuring all required materials are completed and returned within established timelines.
• Examine application packets for accuracy and completeness, then follow up promptly to resolve missing information or supporting documentation.
• Encourage timely submission of signed applications, aiming to secure completed paperwork within 10 days of the original request.
• Partner with credentialing team members to gather outstanding records and keep processing deadlines on track.
• Enter and maintain provider profiles in credentialing platforms and databases, ensuring information remains current and reliable.
• Produce recurring reports on upcoming expirations for licenses, certifications, and related credentials so renewal activity can begin early.
• Monitor renewal status for medical licenses, board certifications, liability coverage, and other required credentials to prevent lapses.
• Escalate unresolved expiration issues as needed and communicate with providers and medical staff offices to confirm active licensure and privileges.

Requirements

• Experience in NCQA Credentialing for the state of IL.
• Experience supporting provider, physician, or healthcare credentialing activities in a clinical, hospital, or managed care environment.
• Working knowledge of initial application processing, reappointment cycles, and standard credentialing documentation requirements.
• Ability to review detailed records carefully and identify incomplete, inaccurate, or missing information.
• Strong organizational skills with the ability to manage multiple deadlines and maintain consistent follow-up.
• Proficiency with Microsoft Excel and comfort using online databases or credentialing systems.
• Effective written and verbal communication skills for coordinating with providers and internal teams.
• High level of accuracy, professionalism, and discretion when handling sensitive provider information.

Benefits

• Medical, vision, dental, and life and disability insurance.
• Eligibility to enroll in the company 401(k) plan.

All applicants applying for U.S. job openings must be legally authorized to work in the United States.