Credentialing Specialist

usebridge.com • Boulder, CO

9d • Remote

About The Position

The Credentialing Specialist manages provider credentialing, enrollment, and re-credentialing with health plans, regulatory bodies, and partner organizations. The role supports accurate, efficient, and compliant credentialing processes in a growing digital health environment, from provider intake through committee-ready files. It also helps improve workflow quality and speed through digital tools, automation, cross-functional coordination, and clear communication with partners and providers.

Requirements

• 2–5+ years of credentialing experience in a high-volume, fast-paced environment, such as digital health, an MSO, or healthcare operations.
• Exceptional written and verbal communication skills; confidence coordinating with internal and external stakeholders and translating complex credentialing issues into clear updates, next steps, and expectations.
• Strong attention to detail and organizational skills, with the ability to manage a large queue of credentialing files across multiple partners.
• Proficiency with startup technology tools such as Google Workspace, Notion, and Slack.

Nice To Haves

• Experience with Salesforce or a similar CRM or credentialing platform, such as Verifiable or Medallion.
• Experience with digital process optimization.
• Strong understanding of NCQA and CAQH requirements.
• Experience with credentialing software such as Verifiable, Medallion, Andros, or CertifyOS.

Responsibilities

• Own end-to-end provider credentialing from intake through committee-ready files, completing primary source verification (PSV) and ensuring compliance with NCQA standards and internal policy.
• Maintain data integrity across systems by reconciling discrepancies and tracking licenses, certifications, training, and expirables so records remain audit-ready.
• Improve throughput and quality using digital tools and automation, and stay current on NCQA, CMS, CAQH, and payer policy changes.
• Collaborate with payer enrollment and partner operations teams to streamline handoffs, resolve problems, and build repeatable processes that improve enrollment speed and quality.
• Support partner and provider communications by helping unblock complex escalations, drafting clear updates, and coordinating internal and external stakeholders as needed.
• Conduct quality assurance on credentialing files against internal rubrics and NCQA standards before committee submission, identifying and resolving discrepancies, time gaps, and red flags.

Benefits

• Foundational role at a company revolutionizing how clinics interact with insurance, with direct partnership with clinic leaders.
• Direct impact on patient access, clinic sustainability, and affordability of care.
• Strong support from leadership and investors; a culture that values experimentation, clarity, and doing the hard stuff right.

What This Job Offers

• Career Level: Mid Level
• Education Level: No Education Listed