Credentialing Specialist

COMPREHENSIVE EYECARE PARTNERS LLC GROUP•Henderson, NV

2d•Onsite

About The Position

Comprehensive EyeCare Partners (CompEye), with twelve ophthalmology practices across Nevada, Washington, Texas, and Utah, is a leader in delivering exceptional patient eye care. All CompEye practices and teammates subscribe to the following Values and Beliefs: Patient Focused: Delivering excellent clinical care is our central purpose. In all we do, we consider the impact on patient safety, clinical outcomes, and patient experience. One Team: We work together collaboratively to get the job done, regardless of role or department. We are all CompEye. We are "one team.“ Compassion & Kindness: We treat others—including patients, teammates, and partners—the way we’d like to be treated, with active listening and understanding. Continuous Innovation: We actively seek ways to improve ourselves, the care we deliver, the clinical innovations that support patients, and how we manage the business. Integrity: We do the right thing even and especially when it’s hard. We hold ourselves accountable. Results Driven: We deliver with a healthy sense of urgency on what we commit to and do what it takes to get the job done. Position Summary The Credentialing Specialist will provide operational and administrative support to the Regional Credentialing Team across multiple regions and practices. This role is responsible for maintaining provider data accuracy, assisting with payer-related updates, supporting onboarding workflows, and ensuring credentialing maintenance tasks are completed in a timely and organized manner.

Requirements

Minimum of three (3) years of credentialing experience required.
Clear understanding of payer enrollment and credentialing process is required.
Familiarity with CAQH, Availity, payer portals, and credential databases is required.
Proficiency in Microsoft suite products: Excel, Word, PowerPoint, and Outlook is required.
Strong organizational and multitasking skills with high attention to detail
Comfortable communicating with insurance payers and provider offices via phone and email
Excellent written and verbal communication skills
Ability to work independently and prioritize tasks in a fast-paced environment.
Ability to maintain professionalism and confidentiality while handling sensitive provider information.
Ability to professionally conduct payer follow-up and escalation calls regarding credentialing and enrollment statuses.

Nice To Haves

Proficient in Adobe Acrobat and DocuSign is preferred
Experience with Monday.com or similar workflow/project management platforms preferred

Responsibilities

Coordinate and submit quarterly insurance directory roster updates for providers and practices across all applicable insurance companies and regions.
Maintain accurate provider demographic information to support payer compliance and patient access.
Update and maintain provider information within payer portals as required.
Manage provider attestations for credentialing databases including CAQH and ProviderSource.
Verify provider information, upload required documentation, and complete attestations within required timeframes.
Assist with maintenance and updates for Insurance Grid projects across all regions.
Collaborate with practice leadership and operational staff to maintain accurate insurance participation information.
Perform data entry and ongoing maintenance within credentialing software systems.
Ensure provider records, credentialing statuses, and timelines remain accurate and up to date.
Assist with maintenance and development of project boards via Monday.com for operational tracking and visibility.
Assist with time-sensitive credentialing and administrative requests as needed.
Communicate professionally with payer representatives via phone and email regarding credentialing matters.
Other duties as assigned