Overview
We are hiring a Provider Credentialing Specialist to manage and verify practitioner credentialing applications, maintain accurate provider data, and ensure compliance with healthcare standards. As a Provider Credentialing Specialist, you will play a key role in delivering a smooth, timely, and accurate credentialing process that supports providers and enhances patient care. This position is ideal for detail-oriented professionals with strong communication skills and experience in credentialing or healthcare operations.
Key Responsibilities for Provider Credentialing Specialist
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Analyze and review credentialing applications, performing primary source verification as required.
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Maintain and update provider files, credentialing systems, and records.
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Respond to internal and external inquiries regarding provider eligibility, participation, and credentialing status.
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Ensure compliance with regulatory, accreditation, and organizational requirements.
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Prepare communications to obtain missing information and follow up with providers promptly.
Skills & Qualifications
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High School Diploma required; Bachelor’s degree in Business, Healthcare Administration, or related field preferred.
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3+ years of experience in physician credentialing, health insurance, or managed care operations (customer service, claims, billing, enrollment, or call center).
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Proficiency in Excel, including Pivot Tables.
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Strong knowledge of medical terminology and credentialing procedures.
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Excellent attention to detail, organizational skills, and communication abilities.
Why Join Us
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Be part of a team that ensures provider compliance and supports patient care.
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Gain experience in credentialing and healthcare operations in a supportive environment.
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Opportunity to develop professionally while making a meaningful impact on provider satisfaction and regulatory compliance.
APPLY