Credentialing Services Specialist

Dean Dorton•Indianapolis, IN

About The Position

The Credentialing Services Specialist manages healthcare provider credentialing and payer enrollment to support efficient reimbursements and uninterrupted patient care. The role oversees applications, licensure tracking, and ongoing compliance across multiple states and payer types, and requires accuracy, organization, confidentiality, and the ability to work effectively in a fast-paced environment. The position is part of Dean Dorton’s Healthcare Consulting team, which helps healthcare organizations improve financial performance, strengthen operations, and enhance patient outcomes. The Specialist works with clients, providers, payer representatives, and internal colleagues, while also contributing to team training, knowledge sharing, and process improvement.

Requirements

At least 2 years of experience in provider credentialing, preferably across multiple payers and specialties.
Familiarity with EFT setup, payer enrollment, and credentialing requirements across multiple states.
Strong attention to detail, organization, and record-keeping skills.
Ability to manage multiple priorities accurately under tight deadlines.
Commitment to confidentiality and compliance with HIPAA regulations.
Strong communication and customer service skills.

Nice To Haves

Experience with Intellisoft and CAQH databases.

Responsibilities

Manage provider credentialing and enrollment with Medicare, Medicaid, and commercial payers.
Initiate payer contracts for new physician practices and monitor revalidations and renewals.
Maintain provider records, including licensure, certifications, malpractice insurance, and DEA registration.
Complete applications and updates in Intellisoft, CAQH, and payer-specific portals.
Track and resolve credentialing-related issues to support uninterrupted claim processing and payment.
Research credentialing requirements and payer policy changes, and share updates with clients and team members.
Ensure compliance with federal, state, and payer-specific credentialing regulations.
Communicate proactively and professionally with clients, providers, and payer representatives.
Manage multiple credentialing projects and deadlines while maintaining quality.
Maintain discretion and comply with HIPAA and confidentiality standards.
Collaborate with internal team members to improve workflows and client satisfaction.
Identify process efficiencies and contribute to team success.
Participate in internal training and development programs to maintain current credentialing knowledge.
Contribute to continuous improvement initiatives within the Healthcare Consulting team.
Document best practices and credentialing updates to support internal knowledge sharing.
Assist in mentoring or cross-training new team members.
Represent the firm’s values of integrity, collaboration, and client service.