Credentialing and Licensing Specialist

📋 Description

• Manage provider credentialing, recredentialing, licensing, payer enrollment, and renewal activities
• Review, validate, and maintain documentation including licenses, certifications, education
• Research and resolve non-routine credentialing, licensing, payer enrollment, and provider data
• Monitor expiration dates, application progress, outstanding documentation, and renewal deadlines to
• Maintain accurate provider records and credentialing databases while safeguarding data integrity.
• Communicate with providers, licensing boards, payers, credentialing committees, regulatory

🎯 Requirements

• High school diploma or equivalent required; an associate degree is preferred.
• 3–5 years of experience in healthcare credentialing, provider licensing, provider enrollment
• In-depth knowledge of credentialing, licensing, payer enrollment, and provider data management
• Working knowledge of regulatory, accreditation, payer, and credentialing requirements.
• Familiarity with NCQA, CMS, state licensing requirements is preferred.
• Experience with credentialing platforms, provider databases, payer portals, HRIS systems, or other

🎁 Benefits

• Remote work opportunity within the United States.
• Full-time employment in a healthcare-focused environment.
• Opportunity to work across provider credentialing, licensing, enrollment, regulatory compliance
• Exposure to audits, accreditation activities, payer requirements, and cross-functional healthcare
• Opportunities to provide guidance and quality support to other credentialing professionals.
• Equal employment opportunity and reasonable accommodation support for qualified applicants.