The Credentialing Specialist is responsible for coordinating, processing, and tracking healthcare provider licenses (MDs, DOs, NPs, RNs, etc.) across multiple U.S. states, including through licensure compacts (IMLC/NLC). This role ensures timely, accurate, and compliant onboarding and re-credentialing of providers in accordance with regulatory and organizational standardsKey Responsibilities:1. State Licensing CoordinationPrepare and submit new license
The Credentialing Specialist is responsible for coordinating, processing, and tracking healthcare provider licenses (MDs, DOs, NPs, RNs, etc.) across multiple U.S. states, including through licensure compacts (IMLC/NLC). This role ensures timely, accurate, and compliant onboarding and re-credentialing of providers in accordance with regulatory and organizational standardsKey Responsibilities:1. State Licensing CoordinationPrepare and submit new license
1. End-to-End Enrollment Managementâ Manage the full-cycle payer enrollment and revalidation process for healthcare providers(Physicians, NPs, PAs, RNs, CRNAs, etc.).â Prepare, review, and submit enrollment applications across Commercial and/or Medicaidpayers.â Track application progress, follow up with payers, and maintain accurate, up-to-datedocumentation.2. Compliance & Regulatory Adherenceâ Ensure compliance with federal, state, and payer-specific
1. End-to-End Enrollment Managementâ Manage the full-cycle payer enrollment and revalidation process for healthcare providers(Physicians, NPs, PAs, RNs, CRNAs, etc.).â Prepare, review, and submit enrollment applications across Commercial and/or Medicaidpayers.â Track application progress, follow up with payers, and maintain accurate, up-to-datedocumentation.2. Compliance & Regulatory Adherenceâ Ensure compliance with federal, state, and payer-specific
Mission of the RoleTo function as the senior-most expert in payer enrollment, providing deep domain leadership, resolving complex escalations, driving process improvements, and enabling the overall team through knowledge development, training, and cross-functional collaboration.Core Responsibilities1. Domain Leadership & Expertiseâ Serve as the primary subject matter expert for all payer enrollment processesâMedicare (PECOS), Medicaid (state-specific),
Mission of the RoleTo function as the senior-most expert in payer enrollment, providing deep domain leadership, resolving complex escalations, driving process improvements, and enabling the overall team through knowledge development, training, and cross-functional collaboration.Core Responsibilities1. Domain Leadership & Expertiseâ Serve as the primary subject matter expert for all payer enrollment processesâMedicare (PECOS), Medicaid (state-specific),