Credentialing Specialist

Description

• THIS POSITION IS NOT REMOTE

• We are looking for a Credentialing Specialist to support provider enrollment and credential verification activities for a healthcare organization in Rochester, New York.

This Long-term Contract position is ideal for someone who can manage detailed compliance documentation, maintain accurate records across credentialing platforms, and work closely with internal teams to keep provider files current. The role requires strong attention to detail, sound judgment when reviewing documentation, and the ability to help maintain regulatory and organizational standards.

Responsibilities:

• Review, organize, and process provider credentialing and recredentialing files to support timely approvals and renewals.
• Verify licenses, certifications, work history, and other required documentation to ensure provider records meet healthcare and compliance standards.
• Maintain accurate information in credentialing databases, CRM tools, EHR systems, and related tracking platforms.
• Prepare audit-ready files by monitoring missing items, updating records, and following up with providers or internal stakeholders as needed.
• Use CAQH and other credentialing resources to validate provider data and streamline application management.
• Generate and manage digital documents using Adobe Acrobat, ensuring forms are complete, accurate, and properly stored.
• Support compliance reviews by identifying discrepancies, escalating issues, and helping enforce established credentialing procedures.
• Coordinate with cross-functional departments to track application status, resolve documentation gaps, and maintain efficient workflow progress. Requirements
• Experience working in credentialing, provider enrollment, or a related healthcare administrative function.
• Knowledge of credentialing workflows, reappointment cycles, and documentation standards within a regulated environment.
• Proficiency with Adobe Acrobat and confidence handling electronic forms and document management tasks.
• Familiarity with

CAQH, EHR

systems, CRM platforms, and database-driven recordkeeping.

• Understanding of auditing practices and compliance expectations tied to healthcare credentialing activities.
• Strong organizational skills with the ability to manage multiple deadlines and maintain precise records.
• Effective written and verbal communication skills for coordinating with providers, payers, and internal teams.

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