License and Credentialing Specialist

Role overview Coordinate provider credentialing and privileging for a healthcare organization and its hospital partners. The specialist manages assigned cases from application through follow-up, keeping provider records accurate and helping ensure submissions, reviews, and related documentation are completed on time and in line with applicable requirements.

Responsibilities - Manage credentialing processes for contracted providers according to organizational standards and relevant federal and state requirements. - Maintain complete, current electronic provider files in credentialing database software. - Coordinate application distribution, receipt, processing, submission, and follow-up for health system clients. - Own assigned provider and hospital cases from initial processing through completion. - Prepare for and coordinate credentialing audits, and assist with organizing and filing FPPE and OPPE records. - Serve as a primary credentialing contact for assigned hospital clients and provider employees or contractors.

Requirements - Three or more years of experience related to credentialing and the responsibilities of the role. - Working knowledge of medical credentialing, privileging, staff policies, and relevant accreditation or certification requirements. - Ability to investigate information, assess findings, and maintain accurate database records. - Proficiency with spreadsheet reporting, including pivot tables and lookup functions. - Strong written, verbal, and interpersonal communication skills, with the ability to work cooperatively across varied groups. - Familiarity with credentialing software or the ability to learn a comparable system quickly.

Nice to have - Certified Provider Credentials Specialist certification, or active progress toward it.

Benefits and work setup - Medical, dental, and vision coverage, a 401(k) plan, and paid time off are offered.