Credentialing Specialist

Carolina Nephrology PA•Greenville, SC

7d•Onsite

About The Position

Carolina Nephrology is seeking an experienced Credentialing Specialist. The ideal candidate will have extensive experience managing provider credentialing in a multi-provider healthcare environment and possess strong proficiency with Qgenda or similar credentialing software. This individual will play a key role in ensuring providers maintain compliance with all credentialing, privileging, and payer enrollment requirements across multiple healthcare settings.

Requirements

Demonstrated experience in healthcare credentialing, payer enrollment, facility credentialing, and CAQH management.
Strong working knowledge of QGenda or similar credentialing software is required.
Experience credentialing providers across multiple healthcare environments, including hospitals, ASCs, dialysis facilities, and physician practices.
Thorough understanding of credentialing regulations, accreditation standards, and payer requirements.
Exceptional organizational, time-management, and communication skills.
Strong attention to detail and ability to manage multiple projects and deadlines simultaneously.
Ability to work independently while maintaining a high level of accuracy and accountability.

Responsibilities

Manage the initial credentialing and re-credentialing processes for 20–40 providers across ambulatory surgery centers, hospitals, dialysis centers, and outpatient clinics.
Oversee payer enrollment and re-enrollment activities, including Medicare, Medicaid, and commercial insurance plans.
Maintain and update provider information within CAQH and other credentialing databases.
Coordinate credentialing and privileging activities with 7–12 hospitals, multiple dialysis organizations, and 20–25 clinic locations.
Manage facility credentialing and ensure organizational compliance with regulatory and accreditation requirements.
Monitor credentialing expiration dates and proactively managing renewals to prevent lapses in provider participation.
Collaborate with physicians, administrators, practice leadership, and external organizations to facilitate timely credentialing approvals.
Maintain accurate credentialing records and ensure compliance with federal, state, payer, and organizational standards.