Credentialing Specialist Lead
The Dermatology Specialists · New York, NY · 8 mo ago
On-siteHealthcareFull-time
Key Responsibilities
- Manage the full credentialing lifecycle for physicians, NPs, and PAs — including Medicaid, Medicare, and commercial payer enrollments (Empire BCBS, Fidelis, Aetna, etc.).
- Review and verify provider documents such as medical licenses, DEA, board certifications, malpractice coverage, and CVs.
- Prepare, track, and submit enrollment applications accurately and within payer timelines.
- Monitor revalidation and re-credentialing schedules to ensure ongoing compliance.
- Serve as the primary point of contact for escalated payer or provider inquiries.
- Partner with internal billing and operations teams to ensure credentialing aligns with billing readiness.
- Maintain credentialing logs, dashboards, and internal trackers for reporting purposes.
- Assist in training and supporting new credentialing specialists, ensuring quality and consistency across workflows.
Qualifications
- 3+ years of healthcare credentialing experience; dermatology or multispecialty experience preferred.
- Strong knowledge of CAQH, NPPES, Medicaid, Medicare, and commercial payer portals.
- Exceptional attention to detail, organization, and follow-through.
- Excellent communication and interpersonal skills.
- Proficiency in Excel and credentialing systems; experience with eClinicalWorks a plus.
Pay
The pay range for this role is: 30 - 32 USD per hour (HEADQUARTERS (HQ))