CREDENTIALING SPECIALIST

CREDENTIALING SPECIALIST Pittsburgh, PA $50,000- $60,000 Are you detail-oriented, organized, and passionate about maintaining high standards in healthcare compliance? We are seeking a Credentialing Specialist to join our client's team and ensure all providers meet the regulatory and organizational standards required to deliver quality care. Be part of a mission-driven team committed to delivering quality care. Opportunities for professional growth and advancement. Competitive benefits, PTO, and work-life balance. OVERVIEW OF THE CREDENTIALING SPECIALIST ROLE: Manage the full credentialing and re-credentialing process for healthcare providers (physicians, NPs, PAs, etc.). Collect, review, and verify all required documentation, licenses, certifications, and background checks. Submit and track applications to insurance plans, hospitals, and other regulatory bodies. Maintain and update credentialing databases and provider files with current information. Monitor expiration dates and proactively initiate the renewal process for licensure and credentials. Communicate regularly with providers, payers, and internal departments to ensure compliance and timely processing. Assist in audits and ensure compliance with NCQA, CMS, and other regulatory requirements. PREFERRED QUALIFICATIONS FOR THE CREDENTIALING SPECIALIST: 2+ years of experience in credentialing or provider enrollment within a healthcare setting. Strong understanding of state and federal credentialing guidelines. Proficient in credentialing software (e.g., CAQH, Availity, or similar platforms). High attention to detail and excellent organizational skills. #INSEP2025 #ZRCFS #LI-BN2 #LI-Hybrid

Created: 2025-09-24