Credentialling Specialist

Provider Credentialing Specialist

Brooklyn NY Full-Time Onsite

$70000 $90000

Position Overview

A growing healthcare organization is seeking a highly organized Provider Credentialing Specialist to take ownership of provider credentialing payer enrollment and compliance activities across a large and expanding provider network.

This is a high-impact role for someone who can bring structure accountability and process improvement to an evolving credentialing function. The ideal candidate is detail-oriented proactive and capable of independently managing credentialing operations while ensuring providers remain compliant and enrolled with all required payers.

Key Responsibilities

Manage provider credentialing and recredentialing processes from start to finish
Verify provider licenses DEA registrations board certifications education work history and malpractice coverage
Maintain accurate credentialing files and supporting documentation
Enroll providers with Medicare Medicaid and commercial insurance carriers
Track enrollment applications and follow up with payers to ensure timely approvals
Manage provider additions updates and terminations with insurance carriers
Maintain and attest CAQH profiles and supporting documents
Monitor expiration dates for licenses certifications malpractice insurance and other credentials
Conduct routine audits to ensure provider compliance and audit readiness
Generate credentialing enrollment and expiration reports
Serve as the primary point of contact for providers regarding credentialing and enrollment matters
Coordinate provider onboarding activities with internal departments
Develop and improve credentialing workflows processes and tracking systems
Utilize to manage projects deadlines and credentialing activities

Qualifications

2 years of provider credentialing and payer enrollment experience preferred
Experience credentialing providers with Medicare Medicaid and commercial insurance plans preferred
Strong knowledge of CAQH PECOS and payer portals preferred
Exceptional organizational skills and attention to detail
Ability to manage multiple providers and deadlines simultaneously
Strong follow-up communication and problem-solving skills
Experience using or similar project management software preferred
Ability to work independently and take ownership of a growing function

What Makes This Opportunity Unique

Opportunity to take ownership of the credentialing department
Significant opportunity for growth and leadership as the organization expands
Direct impact on provider onboarding compliance and operational success
Collaborative and supportive office environment
Medical dental and vision benefits
403(b) with employer match after eligibility period
PTO and vacation accrual program

Email resumes to

Required Experience:

IC