Credentialing and Licensing Specialist

Elevance Health; Town of Colonie (NY); Hybrid; USD 60,000 - 80,000; Full time

Job summary

A leading health company is seeking a Credentialing and Licensing Specialist to manage credentialing processes and maintain records. The role offers hybrid work flexibility, requiring in-office presence 1-2 days a week. Ideal candidates will have at least 3 years of relevant experience, and an AA degree and certification are preferred. Salary ranges from $19.71 to $32.39 hourly based on experience and location.

Benefits

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Qualifications

• Requires a minimum of 3 years of experience in credentialing or provider/practice management.
• An AA degree and Credentialing certification strongly preferred.

Responsibilities

• Maintain files and electronic records.
• Communicate with hospitals regarding initial or re-appointments.
• Track and process license renewals.
• Research new application requirements and manage timelines.

Skills

Credentialing experience

Provider/practice management

File maintenance

Communication

Education

High school diploma or equivalent

Tools

Credentialing software

Job description

Anticipated End Date: 2025-11-28

Position Title: Credentialing and Licensing Specialist

Job Description

Credentialing and Licensing Specialist

Hybrid 1

This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Location(s)

Latham, NY, Boston, MA

Work Shift

Monday -Friday (8:00 AM – 5:00 PM local time)

The Credentialing and Licensing Specialist is responsible for obtaining and processing related documents to ensure credentialing, licensing, and (re)appointment activities for Carelon Health employed practitioners are completed in accordance with established protocols and departmental policies and procedures.

How you will make an impact

• Maintains files and electronic records. Communicates with associates, facilities, and other entities to resolve issues.
• Communicates with hospitals regarding initial or re-appointments, ensuring and coordinating proctoring as needed.
• Assures all dues and fees are paid timely.
• Tracks and processes license renewals, including address changes, status changes, and name changes.
• Researches new application requirements, processes documents, manages timelines, and generates status reports.
• CAQH access & updates
• Collaborative Agreements

Minimum Requirements

Requires a high school diploma or equivalent and a minimum of 3 years of experience in credentialing or provider/practice management or related field; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences

• AA degree and Credentialing certification strongly preferred

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $19.71 to $32.39 (hourly). Locations: Massachusetts; New York. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Job Level

Non-Management Non-Exempt

Workshift

1st Shift (United States of America)

Job Family

PND > Credentialing & Licensing

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, and local laws. Applicants who require accommodation to participate in the job application process may contact [e-mail] for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Please note that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.