Credentialing Specialist

Responsibilities

• Manage initial and ongoing credentialing activities for providers and physicians, ensuring files are complete, accurate, and submitted within required timelines.
• Review applications and supporting documentation to confirm licensure, certifications, work history, and other required credentials.
• Coincide re-credentialing cycles by tracking expiration dates, requesting updated materials, and following up to avoid processing delays.
• Maintain organized credentialing records and update internal databases with current provider information and status changes.
• Communicate with practitioners, internal teams, and external organizations to resolve missing information and support timely approvals.
• Monitor compliance with established credentialing procedures, payer requirements, and applicable standards throughout the process.
• Prepare documentation packets and status updates for audits, committee review, or leadership reporting as needed.

Requirements

• At least 1 year of experience in credentialing, provider credentialing, or physician credentialing.
• Working knowledge of credentialing workflows, including primary source verification and re-credentialing activities.
• Experience reviewing applications and validating documents for accuracy and completeness.
• Ability to manage multiple files and deadlines while maintaining strong attention to detail.
• Clear written and verbal communication skills for coordinating with providers and cross-functional teams.
• Proficiency with data entry, record maintenance, and general administrative systems used in credentialing environments.

Qualifications

The ideal candidate brings hands-on experience with provider and physician credentialing processes and is comfortable managing recurring re-credentialing activities with strong attention to detail.

Skills

• Strong attention to detail
• Clear written and verbal communication skills
• Data entry and record maintenance proficiency
• Knowledge of credentialing workflows

Benefits

TalentMatch® Robert Half offers competitive compensation and benefits, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.