Credentialing Specialist

About the role

The Credentialing Specialist coordinates and manages provider credentialing, recredentialing, privileging, and payer enrollment activities to ensure compliance with policies, regulations, and accreditation standards.

Key responsibilities

• Prepare and submit credentialing and enrollment applications for healthcare providers and track their progress.
• Perform primary source verification of licensure, certifications, education, and training.
• Maintain accurate, confidential credentialing records and monitor ongoing compliance.
• Serve as liaison between providers, payers, regulatory agencies, and internal departments.
• Support medical staff credentialing processes, committee activities, and student/resident credentialing.

Required profile

• High School diploma or equivalent; CPCS certification encouraged.
• 5‑7 years of office experience, preferably in facility provider credentialing.
• Strong organizational, written and verbal communication skills.
• Ability to work independently, handle multiple tasks, and maintain confidentiality.

Required skills

• Proficiency with Microsoft Word and Excel.
• Ability to operate standard office equipment (computer, fax, audio/visual devices).
• Typing speed of at least 55 words per minute.