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Credentialing Specialist

7/25/2025

Remote

Job Summary

A company is looking for a Credentialing Specialist who is passionate about process, detail, and making a meaningful impact behind the scenes.

Key Responsibilities
  • Manage the end-to-end process for onboarding new practitioners, ensuring timely completion of all necessary steps
  • Oversee new practitioner database setup, including demographic entry, onboarding tracking, and primary source verifications
  • Perform NCQA delegation file reviews for all new practitioners and manage the recredentialing process
Required Qualifications
  • High School diploma or equivalent
  • 2+ years of credentialing experience
  • Familiarity with Medicare, Medicaid, and commercial payor enrollment
  • Proficient in Excel, including pivot tables and VLOOKUP
  • A team player who can also work independently and manage multiple priorities

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