Credentialing Specialist

Job Description

REQUIREMENTS

• Bachelor’s Degree Required
• 3+ years of credentialing, healthcare compliance, or related experience
• Experience supporting provider credentialing processes
• Familiarity with healthcare regulatory and accreditation standards
• Experience supporting audits and maintaining compliance documentation
• Proficiency with credentialing systems (MedTrainer experience preferred)
• Exceptional attention to detail

RESPONSIBILITIES

• Serve as the primary point of contact for all credentialing and compliance matters.
• Manage end-to-end provider credentialing, re-credentialing, and privileging processes, including licensure, certifications, CAQH, payer enrollment, and ongoing compliance monitoring.
• Oversee credentialing and certification tracking for nursing, MAs, and other clinical staff, ensuring timely renewals.
• Maintain audit-ready provider credentialing files and documentation for licensure, malpractice coverage, certifications, and regulatory requirements.
• Lead annual compliance follow-ups, trainings, attestations, and continuing education to meet internal, regulatory, and accreditation standards.
• Support audits and compliance initiatives, including vaccine requirements, in partnership with internal teams and committees.
• Maintain and optimize credentialing systems and reporting tools, generating regular compliance updates and identifying workflow improvements.
• Partner cross-functionally with People Operations, Quality Assurance, Clinical and Lab teams to support onboarding, audits, and operational initiatives.
• Develop and refine credentialing workflows, improving efficiency, scalability, and process ownership across the function.

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