Found Description
Job Description
The Senior Credentialing Specialist will oversee and execute all aspects of provider credentialing, re-credentialing, payor enrollment, and facility privileging. You will work closely with internal teams, hospitals, insurance payors, and regulatory bodies to ensure seamless onboarding and compliance for our physician network.
This is a high-impact role for someone who thrives in a fast‑paced environment and is ready to take ownership of the entire credentialing lifecycle.
Responsibilities
- Manage the full credentialing and re-credentialing workflow for physicians and advanced practitioners
- Complete and track payor enrollment applications (Medicare, Medicaid, commercial payors, CAQH, PECOS, NPPES)
- Coordinate facility privileging and ensure compliance with Joint Commission, NCQA, and state-specific regulations
- Maintain accurate and up-to-date provider files, licenses, certifications, and credenti...
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