HR & ADMIN

Credentialing Specialist

Job Description

We are looking for an experienced Credentialing Specialist to manage provider credentialing and enrollment activities while ensuring accurate documentation and compliance with healthcare requirements.

The Credentialing Specialist will coordinate provider enrollment, credentialing, re-credentialing, and verification activities.

This role requires strong attention to detail, excellent documentation skills, and the ability to coordinate with providers, payers, and internal teams.

Key Responsibilities

  • Manage initial and re-credentialing processes for healthcare providers.
  • Prepare and maintain provider credentialing documentation.
  • Complete payer enrollment applications and follow-ups.
  • Verify provider licenses, certifications, and qualifications.
  • Maintain accurate provider records and databases.
  • Track credentialing deadlines and renewal requirements.
  • Communicate with providers and insurance networks.
  • Ensure credentialing activities are completed within required timelines.

Requirements

  • 3+ years of experience in healthcare credentialing or provider enrollment.
  • Knowledge of US healthcare payer enrollment processes.
  • Strong documentation and organizational skills.
  • Excellent attention to detail.
  • Good written and verbal communication skills.
  • Ability to manage multiple credentialing requests simultaneously.

Preferred Skills

Provider CredentialingPayer EnrollmentCAQHProvider EnrollmentHealthcare AdministrationDocumentation Management

Ready to Join CareFirst Solutions?

If you believe this role matches your skills and experience, we would love to hear from you.