Credentialing Specialist - Providers

Senior Doc•Phoenix, AZ

7h•Hybrid

About The Position

GreenWell Health is seeking an experienced and detail-oriented Credentialing Specialist to support provider credentialing and contracting efforts across multiple states. This role is critical in ensuring providers meet all regulatory, payer, and organizational requirements to deliver care efficiently and compliantly.

Requirements

Minimum 5 years of progressive experience in provider credentialing and contracting with insurance companies
Experience credentialing providers across multiple states (Arizona, Nevada and New Mexico preferred)
Strong knowledge of payer enrollment processes, including Medicare and Medicaid
Familiarity with credentialing platforms such as CAQH, PECOS, and NPPES
Excellent attention to detail, organizational, and time management skills
Strong communication and problem-solving abilities
Ability to manage multiple priorities in a fast-paced environment
Knowledge of healthcare regulatory and accreditation standards

Responsibilities

Manage end-to-end provider credentialing, re-credentialing, and privileging processes
Coordinate payer enrollment and contracting for medical groups with commercial and government payers
Ensure compliance with CMS, NCQA, and other regulatory standards
Maintain accurate and up-to-date provider records in credentialing systems
Track and monitor expiring licenses, certifications, and registrations to ensure timely renewals
Communicate with providers to obtain required documentation and resolve discrepancies
Prepare and submit credentialing and enrollment applications to payers and agencies
Collaborate with internal teams to support provider onboarding and operational readiness
Identify and resolve credentialing issues, delays, or denials with payers
Coordinate and support provider onboarding, ensuring all credentialing requirements are completed prior to start date