Credentialing Enrollment Specialist

Jobtailor; Minnesota; On-site; USD 42,000 - 65,000; Full time

Job summary

Jobtailor is seeking a detail-oriented Provider Credentialing Specialist to maintain credentialing data, licenses, CMEs and renewals across hospital and health plan partnerships.

Typical duties include initial and reappointment applications, application review, data verifications, and timely inquiries handling, with a strong emphasis on confidentiality and accuracy in a fast-paced medical office setting.

Qualifications

• Reside in Minnesota or Wisconsin.
• High school diploma or equivalent.
• Associate’s degree preferred.
• Certified Provider Credentialing Specialist (CPCS) preferred.
• 2 years of experience in credentialing or similar medical business office role preferred.
• Ability to work independently with minimal supervision.
• Proficient use of Microsoft Office applications (Outlook, Word, Excel) and internet resources.
• Strong computer and data management skills.
• Understanding of the credentialing process, best practices and applicable regulations.
• Ability to organize work and priorities to meet credentialing and recredentialing deadlines.
• Excellent verbal and written communication skills.
• Excellent attention to detail.

Responsibilities

• Compile and maintain current and accurate data for provider credentialing records
• Maintain provider licenses, certifications, health records and CMEs; track expirations for timely renewals
• Complete provider initial and reappointment applications
• Monitor applications and follow up to support completion
• Review credentialing applications for completeness and accuracy
• Communicate with providers to collect and maintain required information
• Perform verifications of credentialing records
• Assist hospitals and health plans with information needed for provider credentialing files
• Respond to telephone and email inquiries in a timely manner
• Ensure security and confidentiality of credentialing records
• Work with the credentialing manager to identify and resolve credentialing issues
• Perform other related duties as assigned

Skills

Data Management

Attention to Detail

Communication Skills

Organizational Skills

Independence

Problem-Solving

Education

High school diploma or equivalent

Associate’s degree preferred

Certified Provider Credentialing Specialist (CPCS) preferred

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Internet Resources

Job description

• Compile and maintain current and accurate data for provider credentialing records
• Maintain provider licenses, certifications, health records and CMEs; track expirations for timely renewals
• Complete provider initial and reappointment applications
• Monitor applications and follow up to support completion
• Review credentialing applications for completeness and accuracy
• Communicate with providers to collect and maintain required information
• Perform verifications of credentialing records
• Assist hospitals and health plans with information needed for provider credentialing files
• Respond to telephone and email inquiries in a timely manner
• Ensure security and confidentiality of credentialing records
• Work with the credentialing manager to identify and resolve credentialing issues
• Perform other related duties as assigned

Requirements

• Reside in Minnesota or Wisconsin
• High school diploma or equivalent
• Associate’s degree preferred
• Certified Provider Credentialing Specialist (CPCS) preferred
• 2 years of experience in credentialing or similar medical business office role preferred
• Ability to work independently with minimal supervision
• Proficient use of Microsoft Office applications (Outlook, Word, Excel) and internet resources
• Strong computer and data management skills
• Understanding of the credentialing process, best practices and applicable regulations
• Ability to organize work and priorities to meet credentialing and recredentialing deadlines
• Excellent verbal and written communication skills
• Excellent attention to detail

Core Competencies

Demonstrates expertise in provider credentialing processes, including data management, application review, and compliance with regulations. Proficient in maintaining accurate records and ensuring timely renewals while communicating effectively with providers.

Highest-signal resume keywords

• Provider Credentialing
• Data Management
• Microsoft Office Proficiency
• Attention to Detail
• Communication Skills

Hard Skills

• Credentialing Process
• Application Review
• Record Verification
• Data Compilation
• Health Record Management

Soft Skills

• Organizational Skills
• Independence
• Problem-Solving

Certifications & Qualifications

• Certified Provider Credentialing Specialist (CPCS)

Industry Keywords

• Provider Licenses
• CME Tracking
• Credentialing Regulations
• Medical Business Office

Tools & Technologies

• Microsoft Outlook
• Microsoft Word
• Microsoft Excel
• Internet Resources