Job Description Credentialing Specialist & Coordinator Position Summary The Credentialing Specialist is responsible for supporting the facility credentialing, recredentialing, EMR access requests, and CAQH maintenance of providers and staff for a large medical group with more than 200 providers. This position plays an important role in ensuring providers are appropriately credentialed and enrolled while supporting timely onboarding and continuity of operations. The Credentialing Specialist will work as part of a collaborative administrative team and is expected to bring a continuous-improvement mindset to the department. In addition to completing day-to-day credentialing responsibilities, this individual will help identify inefficiencies, strengthen workflows, improve communication, and develop scalable processes as the organization continues to grow. Essential Duties and Responsibilities Provider Credentialing & Recredentialing Manage initial and recurring credentialing activities for facilities. Obtain, verify, organize, and maintain required provider credentials. Monitor credential expiration dates and initiate renewals or follow-up as appropriate. Maintain accurate provider demographic and credentialing information. Conduct and document required primary source verifications. Payer Enrollment Prepare and submit enrollment, revalidation, and demographic-change requests. Track applications through completion and follow up on outstanding items. Maintain accurate payer participation and enrollment records. Communicate credentialing or enrollment barriers that may impact provider operations or billing. Facility Credentialing Complete credentialing and privileging applications as required by healthcare facilities and organizational partners. Coordinate requested documentation with providers and internal departments. Track outstanding applications, approvals, renewals, and expirations. Provider Onboarding Partner with Operations and other departments during the onboarding of new providers. Initiate credentialing activities promptly and communicate potential delays or outstanding requirements. Maintain visibility into credentialing status throughout the onboarding process. Tracking & Compliance Maintain organized electronic credentialing records. Monitor licenses, certifications, DEA registrations, malpractice insurance, and other required credentials. Maintain accurate supporting documentation for credentialing audits and operational reviews. Protect confidential provider information and follow organizational privacy and security requirements. Process Improvement Evaluate existing credentialing workflows and identify opportunities for greater efficiency, accuracy, and visibility. Recommend solutions for recurring credentialing or enrollment issues. Help develop standardized checklists, trackers, workflows, and documentation. Participate in departmental initiatives designed to improve service to providers and internal stakeholders. Support the development of credentialing processes that can scale with organizational growth. Team Expectations We believe a strong credentialing department depends on teamwork, communication, accountability, and shared ownership . The successful candidate will be expected to: Be a collaborative and dependable team member. Communicate openly and professionally. Share knowledge and help teammates succeed. Take ownership rather than waiting for problems to escalate. Approach challenges with a solution-oriented mindset. Be receptive to new ideas, technology, and workflow improvements. Respect established processes while being willing to recommend better ones. Keep the provider experience and overall organizational goals in mind. Contribute to a positive culture focused on continually improving the services we provide. Experience with CAQH, NPPES, PECOS, Medicare/Medicaid enrollment, commercial payers, and professional credential tracking is preferred. Most importantly, we're looking for a like-minded team player who wants to help us build a stronger credentialing operation as our organization continues to grow.

Pay:

$25.70 - $30.95 per hour Expected hours: 40.0 per week

Benefits:

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

Work Location:

In person