Insurance credentialing

Position Overview

We are seeking a detail-oriented and highly organized
Insurance Credentialing Specialist
to manage the end-to-end credentialing and re-credentialing process for healthcare providers. This role ensures that providers are properly enrolled, credentialed, and compliant with insurance carriers, state regulations, and organizational requirements.

The ideal candidate is proactive, experienced in insurance portals, and comfortable handling follow-ups with payers while maintaining accurate records and deadlines.

Key Responsibilities

• Manage initial credentialing and re-credentialing for providers with insurance companies and government payers
• Prepare, submit, and track credentialing and enrollment applications
• Maintain provider files with up-to-date licenses, certifications, malpractice insurance, and required documentation
• Follow up with insurance carriers to resolve pending or denied applications
• Monitor re-credentialing cycles and ensure timely renewals
• Communicate with providers to collect missing or updated documentation
• Maintain accurate credentialing records, reports, and tracking spreadsheets or systems
• Ensure compliance with payer requirements, internal policies, and regulatory standards
• Coordinate with billing and operations teams to ensure providers are activated correctly

Qualifications & Skills

• Previous experience in insurance credentialing (healthcare setting required)
• Strong knowledge of insurance enrollment processes and payer portals
• Excellent organizational and time-management skills
• High attention to detail and accuracy
• Strong written and verbal communication skills
• Ability to manage multiple providers and deadlines simultaneously
• Proficiency with credentialing software, spreadsheets, and online portals
• Advanced or near-native English level