Credentialing Specialist

About This Role

This contract opportunity with permanent potential is for a Credentialing Specialist to support provider enrollment and credentialing operations for a healthcare organization. The role is ideal for someone who can manage detailed compliance documentation, maintain accurate records, and coordinate efficiently with providers and internal leadership. You will help keep credentialing activities moving on schedule while ensuring regulatory and organizational standards are met.

Responsibilities

• Manage initial and ongoing credentialing activities for medical staff and advanced practice providers, ensuring each file moves through the process accurately and within expected timelines
• Review applications for completeness, follow up with practitioners on missing items, and document outstanding requirements or compliance gaps that need resolution
• Maintain provider records in the credentialing database with a high degree of accuracy, including updates related to recredentialing and ongoing status tracking
• Track time-sensitive documents such as licensure, liability coverage, DEA registrations, certifications, and immunization records to help prevent lapses in compliance
• Prepare verified credentialing files for leadership review by organizing supporting documentation and confirming that all required elements are included
• Communicate regularly with provider offices and internal stakeholders to support a smooth credentialing process and respond to questions or requests for clarification
• Monitor proctoring, peer review, and other ongoing provider oversight activities, escalating issues when additional follow-up is needed
• Process affiliation verifications, produce case logs when requested, and assist with special projects or additional assignments from departmental leadership

Requirements

• At least 2 years of experience in credentialing, provider enrollment, or a closely related healthcare administrative function
• Working knowledge of credentialing standards and applicable state, federal, and organizational compliance requirements
• Proficiency with Microsoft Office applications, including Outlook, Word, and Excel, along with the ability to learn and navigate credentialing and EHR-related systems
• Experience maintaining detailed databases and performing accurate data entry for credentialing and recredentialing records
• Strong organizational skills with the ability to manage multiple priorities, meet firm deadlines, and remain effective in a fast-paced environment
• Clear written and verbal communication skills for interacting with providers, office staff, and internal leadership
• High attention to detail, sound judgment, and the ability to handle confidential provider information with discretion

Nice to have: