Credentialing Analyst - Full time

Southern New Hampshire Health; Nashua (NH); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Disability coverage

401(k)/403(b) plan

Tuition reimbursement

PTO

Job summary

Southern New Hampshire Health is seeking a Credentialing Analyst to support onboarding and credentialing for 340+ providers across Foundation Medical Partners and Southern NH Medical Center. This role ensures timely payer enrollment and accurate credentialing data in CAQH.

Ideal candidates have two years of healthcare credentialing experience, strong Microsoft Office skills, and exceptional attention to detail.

Qualifications

• Two years of healthcare office experience in credentialing preferred.
• Bachelor's degree not required but CPCS is a strong plus.

Responsibilities

• Initiates the Medical/Allied Health Professional Staff appointment application process
• Outlines licensing and DEA requirements for NH and MA
• Verifies education contact information
• Initiates/Updates Professional Liability Insurance
• Prepares insurance applications for provider to complete and sign
• Completes/updates credentialing data in CAQH
• Initiates/enrollment with insurance plans
• Follows up with insurance plan on provider effective date
• Updates plans with provider changes
• Assists Business Office with resolving claim issues due to enrollment
• Data entry in credentialing software for license, DEA and board expirations
• Runs reports on expiring credentials
• Follows up on expiring credentials to ensure compliance
• Researches Federal, State and Local licensing guidelines
• Maintains confidentiality of sensitive information
• Prioritizes tasks to meet deadlines

Skills

Attention to detail

Time management

Communication skills

Discretion

Microsoft Office

Education

High School diploma or equivalent

Certified Provider Credentialing Specialist (CPCS)

Tools

CAQH

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Who We Are

Southern New Hampshire Health has been a cornerstone of the region since 1893, delivering high-quality, compassionate care close to home. Anchored by Southern New Hampshire Medical Center—a 188-bed, DNV-accredited hospital in downtown Nashua with a Level III-N trauma center, Level II Special Care Nursery, and Magnet® designation for nursing excellence—we offer a full spectrum of services from primary care to advanced diagnostics and specialized treatments. Our medical staff includes over 500 providers from Foundation Medical Partners, and local practices. Foundation Medical Partners, our multi-specialty group, spans 70+ practices across southern New Hampshire and northern Massachusetts, providing coordinated, patient-centered care to thousands each year.

About The Job

The credentialing analyst position assists the manager in overseeing the credentials and enrollments for over 340 providers in Foundation Medical Partners and also assists the credentialing analyst at Southern NH Medical Center in onboarding new providers. This person also oversees the onboarding of new providers who will be providing services to Foundation Medical Partners. This position is vital to new providers starting on their anticipated start date to meet the clinical needs of the practice they are hired into. This allows the practice to maintain (if we are replacing a provider) or grow their patient access (if we are hiring an additional provider). The other vital component of this position is to get the provider enrolled with the payers our organization contracts with as soon as possible. This ensures our organization will be paid for the services they provide to our patients. With the robust activity of recruitment and the challenges of payer enrollments this position is essential in meeting our organization's goal of growing primary care, cardiovascular services, cancer care, digestive health, orthopedics, neurosciences and emergency/urgent care while also growing our financial strength.

What You’ll Do

• Initiates the Medical/Allied Health Professional Staff appointment application process
• Outlines licensing and DEA requirements for NH and MA
• Verifies education contact information
• Initiates/Updates Professional Liability Insurance
• Prepares insurance applications for provider to complete and sign
• Completes/updates provider credentialing data in the universal Provider Data Source CAQH
• Initiates/maintains enrollment with insurance plans
• Follows up with insurance plan of provider effective date
• Updates insurance plans with provider/practice change of information
• Assists the Business Office with resolving claim processing issues due to provider enrollment
• Data entry in the credentialing software system of all provider license, DEA and Board Certification expirations
• Runs reports to notify provider and manager of expiring credentials
• Follows up on all expiring credentials to ensure compliance with provider employment agreement
• Researches Federal, State and Local guidelines for licensing and maintaining credentials
• Has exceptional attention to detail
• Has excellent verbal and written communication skills
• Has the ability to prioritize tasks to meet strict deadlines

Who You Are

• Experienced: You possess at least two (2) years of healthcare office experience specifically within a credentialing role (experience in a medical staff services department is preferred).
• Educated & Certified: You hold a High School diploma or equivalent. A Certified Provider Credentialing Specialist (CPCS) designation is a strong plus.
• Tech-Savvy: You are proficient with Microsoft Office Suite, particularly Word, Excel, and Outlook, with the ability to maintain complex databases.
• Detail-Oriented & Organized: You have exceptional time-management skills, a keen eye for detail, and the ability to multitask effectively under tight deadlines.
• Discreet: You possess a demonstrated ability to properly handle and protect highly confidential, sensitive information.

Why You’ll Love Us

• Health, dental, prescription, and vision coverage for full-time & part-time employees
• Short-term, long-term disability, life & pet insurance
• Tuition reimbursement & Nursing Student Loan Paydown Program
• 403(b) Retirement savings plans
• Continuous earned time accrual & more!