Credentialing Specialist

Key Responsibilities

• Manage end-to-end credentialing for providers from intake through approval
• Build and maintain provider profiles in Modio
• Track credentialing workflows and progress in JIRA
• Perform primary source verification, including licenses, education, board certifications, DEA, and other required credentials
• Conduct sanction screenings (OIG, SAM, NPDB) and complete compliance reviews
• Partner cross-functionally to move providers from Credentialing Approved to Clear to Practice (CTP)
• Communicate with providers to ensure timely completion of credentialing applications and required documentation
• Maintain accurate credentialing records and support compliance requirements

Requirements

• 2+ years of provider credentialing experience; telehealth or multi-state credentialing experience preferred
• Strong understanding of primary source verification (PSV) and healthcare compliance requirements
• Experience with credentialing platforms; experience with Modio is preferred
• Strong attention to detail and ability to manage multiple providers and deadlines
• Excellent organizational, communication, and follow-up skills
• Ability to work effectively with cross-functional teams in a fast-paced environment