We are looking for a Credentialing Specialist to support provider enrollment and reappointment activities. This long-term contract position focuses on coordinating accurate, timely credentialing documentation, maintaining provider records, and helping ensure licenses and certifications remain current. The ideal candidate brings strong follow-through, sound judgment, and the ability to work closely with providers and internal stakeholders to keep credentialing workflows on schedule.

Responsibilities:

• Experience in NCQA Credentialing for the state of IL
• Guide healthcare providers through initial credentialing and recredentialing submissions, ensuring all required materials are completed and returned within established timelines.
• Examine application packets for accuracy and completeness, then follow up promptly to resolve missing information or supporting documentation.
• Encourage timely submission of signed applications, aiming to secure completed paperwork within 10 days of the original request.
• Partner with credentialing team members to gather outstanding records and keep processing deadlines on track.
• Enter and maintain provider profiles in credentialing platforms and databases, ensuring information remains current and reliable.
• Produce recurring reports on upcoming expirations for licenses, certifications, and related credentials so renewal activity can begin early.
• Monitor renewal status for medical licenses, board certifications, liability coverage, and other required credentials to prevent lapses.
• Escalate unresolved expiration issues as needed and communicate with providers and medical staff offices to confirm active licensure and privileges.