Credentialing Specialist

Job Summary

A company is looking for a Credentialing Specialist.

Key Responsibilities

• Oversee all aspects of provider credentialing and payer enrollment for the assigned region
• Ensure compliance with health plan requirements and maintain up-to-date provider data in credentialing databases
• Coordinate with regional leadership to facilitate timely onboarding and renewal of provider credentials

Required Qualifications

• Bachelor's degree in a related field preferred
• Minimum of three years' experience in managed care credentialing or medical staff services required
• National or multi-state credentialing experience preferred
• Strong knowledge of NCQA, Joint Commission, URAC, CMS, and state laws related to credentialing
• Ability to function independently in a matrix environment