About This Role
This role is critical to ensuring the practice's providers are credentialed, compliant, and able to focus on delivering exceptional patient care. The Credentialing Specialist manages the end-to-end credentialing process for a growing, patient-focused ENT practice.
Responsibilities
- Manage end-to-end provider credentialing and re-credentialing with insurance payers, hospitals, and facilities
- Prepare, submit, and track credentialing applications accurately and efficiently
- Maintain provider files to ensure compliance with payer, regulatory, and accreditation requirements
- Serve as a point of contact with payers, providers, and internal teams regarding credentialing status
- Monitor expiration dates for licenses, certifications, DEA registrations, and enrollments
- Support new provider onboarding and expansions within the practice
Requirements
- Minimum 3 years’ experience in the credentialing field
- Proven experience in medical credentialing (ENT or specialty practice experience a plus)
- Strong knowledge of payer enrollment processes, CAQH, and credentialing timelines
- Exceptional attention to detail and organizational skills
- Ability to manage multiple priorities in a fast-paced healthcare environment
- Professional communication skills and a collaborative mindset
- Proficient with Microsoft Applications (Word, Excel, Outlook) and Windows
- Strong data entry skills
- Professional written and spoken communication skills
- Working knowledge of Credential My Doc Software (will be taught)
- High level of attention to detail
- Ability to handle multiple documents pertaining to several providers at once
- Applying complex, detailed guidelines in the preparation and review of all applications to ensure compliance with CMS, state regulations, NCQA and internal procedures and protocols
- Excellent time management skills to handle multiple tasks simultaneously
- Demonstrated ability to work independently and prioritize work
- Team orientation and flexibility in accepting change
Nice to have:
- CPCS (Certified Provider Credentialing Specialist) preferred
Benefits
- Opportunity to work with a respected ENT group committed to quality and growth
- Supportive, collaborative administrative team
- Opportunity to contribute to streamlined processes and practice expansion
- Stable, professional environment with long-term growth potential
About the Company
This is a well-established and expanding Ear, Nose & Throat (ENT) medical group.