Lead Credentialing Associate

Comprehensive Rehab Consultants

7d

About The Position

Comprehensive Rehab Consultants (CRC) is a premier provider of physiatry and post-acute care services. We specialize in partnering with skilled nursing facilities and rehabilitation centers to optimize patient outcomes through expert clinical leadership. Our mission is to radically improve the health, happiness, and dignity of the residents we serve by delivering high-quality, value-based care. As we continue our rapid expansion, we are seeking a seasoned credentialing professional to lead our enterprise-wide provider enrollment efforts.
The Lead Credentialing Associate ensures that the provider network consists of clinicians who meet all regulatory criteria to minimize company liability and maximize patient safety. This role requires vast experience in all types of credentialing, with a specialized emphasis on Medicare and Medicaid enrollment. Beyond technical processing, the Lead Manager acts as a team mentor, providing guidance and subject matter expertise to junior specialists to ensure production goals and quality standards are met.

Requirements

• High school diploma or equivalent required; College Degree strongly preferred.
• Vast experience in all facets of medical credentialing, specifically medical credentialing and privileging procedures and standards.
• Must be proficient in Microsoft Office (Word and Excel) and a variety of relevant computer programs.
• Excellent verbal and written communication skills.
• Exceptional attention to detail and ability to maintain a high level of confidentiality for provider information.

Nice To Haves

• Credential Specialist Certification (CPCS or CPMSM) preferred.

Responsibilities

• Lead the enterprise-wide enrollment process for Medicare (PECOS) and various State Medicaid programs (including PAVE/Medi-Cal) to ensure uninterrupted billing.
• Serve as the primary point of escalation and mentor for the credentialing team, providing training on complex enrollment workflows and regulatory changes.
• Review complex credentialing and recredentialing applications for accuracy and completeness based on diverse provider specialties.
• Maintain professional communication with healthcare providers to clarify questions and request missing information.
• Update and maintain credentialing software systems with accurate information to ensure data integrity.
• Conduct rigorous ongoing monitoring of provider expirables, such as licenses and DEA certificates, and summarize records for monthly Credentialing Committee review.
• Review and process federal and state license sanctions and exclusion reports (OIG/SAM) and NPDB Continuous Query reports.
• Contribute to quarterly quality improvement reports and distribute weekly status updates to the contracting department regarding upcoming provider terminations.
• Assist with Delegation Oversight audit reviews, tracking, and reporting to maintain high-level compliance with payer partners.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED