Credentialing Specialist

LHH Recruitment Solutions; Nashville (TN); Sur place; USD 55 000 - 75 000; Plein temps

Avantages offerts par ce poste

PTO

Medical insurance

Dental insurance

Vision insurance

Life insurance

Short-term disability

401K

Résumé du poste

Nashville-based healthcare client is seeking a Credentialing Specialist to join their team. This role focuses on credentialing, enrollment, and ongoing compliance to support patient care and operational success.

Ideal candidates bring 3+ years in credentialing or healthcare administration, with strong knowledge of Medicare/Medicaid and payer enrollment, and proficiency in Microsoft Office.

Qualifications

• 3+ years of credentialing, provider enrollment, medical staff services, or healthcare administration experience preferred.
• Knowledge of healthcare credentialing processes, payer enrollment, and provider licensing requirements.
• Strong knowledge of Medicare, Medicaid, and commercial payer enrollment procedures.
• Proficiency with Microsoft Office, including Excel and Outlook.

Responsabilités

• Coordinate initial credentialing, recredentialing, and provider enrollment activities for physicians, advanced practice providers, and other healthcare professionals.
• Collect, verify, and maintain provider credentials, including licenses, certifications, education, training, malpractice coverage, and work history.
• Prepare and submit credentialing applications to hospitals, health systems, insurance payers, and regulatory agencies.
• Monitor expiration dates and ensure timely renewal of provider licenses, certifications, DEA registrations, and other required documentation.
• Maintain accurate provider records within credentialing databases and systems.
• Respond to credentialing inquiries from providers, payers, and internal stakeholders.
• Track application status and follow up with insurance carriers and credentialing entities to resolve delays.
• Collaborate with provider relations, revenue cycle, medical staff, and operations teams to support onboarding and ongoing compliance.

Connaissances

Organizational skills

Attention to detail

Communication skills

multitasking

Outils

Microsoft Office Suite

Excel

Outlook

Description du poste

Our growing healthcare client in Nashville is seeking a highly organized and detail-oriented Credentialing Specialist to join their expanding team. This individual will play a critical role in ensuring healthcare providers are properly credentialed, enrolled, and compliant with regulatory, payer, and organizational requirements.

This is an excellent opportunity for a healthcare professional who thrives in a fast-paced environment and enjoys managing complex processes that directly support patient care and operational success.

Key Responsibilities

• Coordinate initial credentialing, recredentialing, and provider enrollment activities for physicians, advanced practice providers, and other healthcare professionals
• Collect, verify, and maintain provider credentials, including licenses, certifications, education, training, malpractice coverage, and work history
• Prepare and submit credentialing applications to hospitals, health systems, insurance payers, and regulatory agencies
• Monitor expiration dates and ensure timely renewal of provider licenses, certifications, DEA registrations, and other required documentation
• Maintain accurate provider records within credentialing databases and systems
• Respond to credentialing inquiries from providers, payers, and internal stakeholders
• Track application status and follow up with insurance carriers and credentialing entities to resolve delays
• Collaborate with provider relations, revenue cycle, medical staff, and operations teams to support onboarding and ongoing compliance

Qualifications

• 3+ years of credentialing, provider enrollment, medical staff services, or healthcare administration experience preferred
• Knowledge of healthcare credentialing processes, payer enrollment, and provider licensing requirements
• Strong knowledge of Medicare, Medicaid, and commercial payer enrollment procedures
• Proficiency with Microsoft Office, including Excel and Outlook
• Excellent organizational skills with strong attention to detail
• Ability to manage multiple deadlines and prioritize effectively
• Strong written and verbal communication skills

Benefit offerings include PTO, medical, dental, vision, life insurance, short-term disability, and 401K plan. Provides employees the flexibility to choose the type of coverage that meets their individual needs.