Credentialing Specialist

Credentialing Specialist

Location: Hybrid Schedule – In person 3 days per week

Employment Type: Full-Time

About the Role

We are seeking a detail-oriented and highly organized Credentialing Specialist to support and provide backup for our credentialing department. This role ensures the efficient and timely processing of medical staff privileges for hospitals, clinics, imaging facilities, and contracted payors for all physicians and Advanced Practice Professionals (APPs). The ideal candidate thrives in a fast-paced environment, communicates professionally, and maintains exceptional accuracy in all credentialing activities.

Key Responsibilities

• Submit initial and reappointment credentialing applications for physicians and APPs within designated timelines.
• Manage all tasks related to credentialing for physicians, imaging centers, and clinics across participating payors, managed care plans, and government insurance programs.
• Monitor initial appointment, reappointment, and expirable processes to ensure compliance with RADNTX JCAHO Staff Bylaws, Rules and Regulations, and internal policies.
• Provide timely follow-up on all applications in progress.
• Serve as a liaison between providers, payors, clinics/IDTFs, and organizational leadership in collaboration with the Credentialing Manager and Revenue Director.
• Ensure accurate and timely completion of provider enrollment processes for all contracted payors and clinics/IDTFs.
• Utilize the credentialing database to streamline application processing, tracking, and document management.
• Generate and maintain credentialing reports to support compliance with organizational and regulatory standards.
• Maintain up-to-date and accurate information within the credentialing database.
• Respond promptly and professionally to credentialing-related inquiries via phone, fax, or email.
• Deliver high-quality customer service with courteous, timely, and solutions-oriented communication.
• Recommend improvements to credentialing procedures and workflows.
• Assist with special or large-scale projects within the credentialing department.
• Ensure all credentialing-related office equipment is functioning properly and report issues for timely resolution.
• Maintain regular, reliable attendance to meet credentialing and provider enrollment deadlines.

Qualifications

Required

• High school diploma or GED preferred; candidates with 2–5+ years of directly related experience will also be considered.
• Strong organizational skills with exceptional attention to detail.
• Excellent communication and customer service skills.
• Ability to manage multiple priorities and meet strict deadlines.

Preferred

• Minimum of 1–2 years of experience in healthcare credentialing, provider enrollment, or a related field.
• Knowledge of commercial insurance, managed care, and government payors.

Work Environment & Expectations

• Fast-paced, deadline-driven environment.
• High level of collaboration with internal teams and external stakeholders.
• Strong commitment to accuracy, compliance, and timely execution of responsibilities.

Why Join Us

• Opportunity to support critical healthcare operations
• Competitive benefits package including 401K match + profit sharing, employee paid medical premium + health savings account funding, free Telehealth visits, gym reimbursement, tuition reimbursement, parental leave, volunteer opportunities, once the waiting period has been completed.
• Contribute to a department that plays a critical role in ensuring patient access to high-quality care.