Credentialing and Licensing Specialist

About the role

The Credentialing and Licensing Specialist oversees payer enrollment, credentialing, re‑credentialing, and regulatory reporting to ensure the company remains in good standing with government‑funded programs, managed care organizations, and commercial insurers.

Key responsibilities

• Process and complete enrollment, revalidation, and credentialing applications for Medicare, Medicaid, managed care and commercial payers.
• Maintain and update payer information, demographic data, licensure records, and EDI enrollment in the company’s billing systems.
• Manage all company licenses, state DME permits, supplier registrations and accreditation renewals.
• Prepare and submit ownership disclosures, adverse action reports and other regulatory filings.
• Support the Market Access Team with credentialing initiatives for commercial contracts.

Required profile

• High school diploma or equivalent; associate degree preferred.
• 3‑5 years of experience in healthcare administration, payer enrollment, credentialing or licensing.
• Strong organizational, time‑management and problem‑solving abilities.
• Excellent verbal and written communication skills.

Required skills

• Proficiency with Microsoft Office Suite.
• Experience using payer portals and related enrollment systems.

What we offer

• Comprehensive medical, dental, and vision insurance.
• Competitive 401(k) plan with immediate company match.
• Generous paid time off, flexible work hours and hybrid options where available.
• Professional development programs, tuition reimbursement and mentorship.
• Employee recognition programs and wellness resources.