Medical Credentialing Specialist

About the Role We are seeking a detail-oriented and highly organized Credentialing Specialist to join our growing team. In this role, you will be responsible for managing provider credentialing, licensing, payer enrollments, and hospital privileging processes while ensuring compliance with regulatory and organizational standards. The ideal candidate thrives in a fast-paced healthcare environment, communicates professionally with providers and staff, and is passionate about maintaining accurate records and delivering exceptional administrative support. Key Responsibilities Provider Credentialing & Enrollment Coordinate and assist billing company with necessary documentation for payer credentialing, including Medicare and Medicaid. Obtain, review, and verify all required documentation for accuracy and completeness. Prepare and submit enrollment and credentialing applications in a timely manner. Track application statuses and proactively follow up to ensure deadlines are met. Maintain strict confidentiality and compliance with HIPAA and organizational policies. Serve as a point of contact for providers, leadership, and external agencies regarding credentialing matters. Hospital & Facility Privileging Facilitate hospital and facility privilege applications for physicians and providers. Collect and verify supporting documentation required for privileging. Ensure providers obtain privileges prior to onboarding or scheduled start dates. Monitor expiration dates and renewal requirements. Medical License Management Coordinate initial and renewal medical licensure processes as needed. Maintain accurate provider license records and renewal timelines. Ensure provider records remain compliant with state and federal requirements. Credentialing Database & Record Maintenance Maintain credentialing software and provider databases with current information. Track application statuses, CME documentation, expirations, and renewals. Upload and organize provider records and credentialing documents electronically. Maintain accurate provider files and audit-ready documentation. Provide internal support regarding provider data and credentialing records. Administrative Support Support leadership and office operations with various administrative tasks. Coordinate meetings, scheduling, and vendor communications as needed. Order office supplies and assist with general office management functions. Assist with staff communication and operational coordination. Qualifications High school diploma or equivalent required; Associate's or Bachelor's degree preferred. 2+ years of credentialing, provider enrollment, or healthcare administration experience preferred. Knowledge of provider credentialing, payer enrollment, and hospital privileging processes. Experience with credentialing or practice management software preferred. Understanding of HIPAA compliance and healthcare regulations. Strong attention to detail and organizational skills. Excellent verbal and written communication skills. Ability to manage multiple priorities and meet deadlines in a fast-paced environment. Proficiency in Microsoft Office Suite and healthcare systems/software. Preferred Skills Strong problem-solving and follow-up skills. Ability to work independently while collaborating effectively with cross-functional teams. What We're Looking For A collaborative team player who is willing to support colleagues and organizational goals. A positive, adaptable professional who embraces change and continuous improvement. Someone who is solutions-oriented and committed to providing excellent service to providers and staff.

Qualifications:

Education:

High school diploma or equivalent required; associate or bachelor's degree in business administration, healthcare administration, or related field preferred.

Experience:

2+ years of experience in an Credentialing role, preferably within a medical or healthcare setting.

Skills:

Excellent organizational and multitasking abilities. Strong communication skills (both verbal and written). Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)

Key Attributes:

High attention to detail and confidentiality. Ability to prioritize tasks and meet deadlines in a fast-paced environment. Strong interpersonal skills with a customer-service-oriented mindset. Proactive problem-solving and decision-making abilities.

Job Type:

Full-time Pay:

$20.00 - $22.00 per hour

Benefits:

401(k) Dental insurance Health insurance Paid time off Vision insurance

Work Location:

In person