Credentialing Specialist (

usebridge.com • Remote,

6d • Remote

About The Position

The Credentialing Specialist manages provider credentialing, enrollment, and re-credentialing with health plans, regulatory bodies, and partner organizations. This contract role supports accurate, efficient, and compliant credentialing processes in a growing digital health environment, with responsibility for provider files from intake through committee-ready submission. The position requires applying credentialing best practices and compliance requirements while using digital tools to streamline workflows.

The specialist works with payer enrollment and partner operations teams, communicates with providers and partners, helps resolve escalations, and conducts quality assurance on credentialing files. The role is remote and reports to the Lead Credentialing Specialist.

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, including the ability to coordinate across internal and external stakeholders and explain complex credentialing issues clearly.
• Strong attention to detail and organizational skills, with the ability to manage a large queue of files across multiple partners.
• Proficiency with startup technology tools such as Google Workspace, Notion, and Slack.
• Strong understanding of NCQA and CAQH requirements and/or experience using credentialing software such as Verifiable, Medallion, Andros, or CertifyOS.

Nice To Haves

• Experience with Salesforce or similar CRM or credentialing platforms, such as Verifiable or Medallion.
• Experience with digital process optimization.

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 by leveraging digital tools and automation and staying current on NCQA, CMS, CAQH, and payer policy changes.
• Collaborate with payer enrollment and partner operations teams to streamline handoffs, solve problems, and build repeatable processes that improve enrollment speed and quality.
• Support partner and provider communications by helping resolve complex escalations, drafting updates, and coordinating internal and external stakeholders.
• 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

• Opportunity to be a foundational member of a company changing how clinics interact with insurance, with direct partnership with clinic leaders.
• Work with direct impact on patient access, clinic sustainability, and affordability of care.
• Leadership and investor support and a culture that values experimentation, clarity, and doing the hard work correctly.

What This Job Offers

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