Credentialling Specialist
Mai Placement•Brooklyn, NY
•Onsite
About The Position
A growing healthcare organization is seeking a highly organized Provider Credentialing Specialist to take ownership of provider credentialing, payer enrollment, and compliance activities across a large and expanding provider network. This is a high-impact role for someone who can bring structure, accountability, and process improvement to an evolving credentialing function. The ideal candidate is detail-oriented, proactive, and capable of independently managing credentialing operations while ensuring providers remain compliant and enrolled with all required payers.
Requirements
- Exceptional organizational skills and attention to detail
- Ability to manage multiple providers and deadlines simultaneously
- Strong follow-up, communication, and problem-solving skills
- Ability to work independently and take ownership of a growing function
Nice To Haves
- 2+ years of provider credentialing and payer enrollment experience preferred
- Experience credentialing providers with Medicare, Medicaid, and commercial insurance plans preferred
- Strong knowledge of CAQH, PECOS, and payer portals preferred
- Experience using Monday.com or similar project management software preferred
Responsibilities
- Manage provider credentialing and recredentialing processes from start to finish
- Verify provider licenses, DEA registrations, board certifications, education, work history, and malpractice coverage
- Maintain accurate credentialing files and supporting documentation
- Enroll providers with Medicare, Medicaid, and commercial insurance carriers
- Track enrollment applications and follow up with payers to ensure timely approvals
- Manage provider additions, updates, and terminations with insurance carriers
- Maintain and attest CAQH profiles and supporting documents
- Monitor expiration dates for licenses, certifications, malpractice insurance, and other credentials
- Conduct routine audits to ensure provider compliance and audit readiness
- Generate credentialing, enrollment, and expiration reports
- Serve as the primary point of contact for providers regarding credentialing and enrollment matters
- Coordinate provider onboarding activities with internal departments
- Develop and improve credentialing workflows, processes, and tracking systems
- Utilize Monday.com to manage projects, deadlines, and credentialing activities
Benefits
- Medical, dental, and vision benefits
- 403(b) with employer match after eligibility period
- PTO and vacation accrual program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
