Credentialing Specialist

Ezra Medical Center; New York (NY); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

401(k)

Disability Insurance

Health Insurance

Life Insurance

Paid Time Off

Vision Insurance

Job summary

Ezra Medical Center in Brooklyn, NY is seeking an experienced Credentialing Specialist to ensure providers are properly credentialed, enrolled, and maintained with Medicare, Medicaid, and commercial carriers.

You will manage CAQH, payer enrollments, and CAQH with Monday.com, coordinating with providers and internal teams to keep credentialing on track and compliant. Strong attention to detail and communication are essential.

Qualifications

• 3+ years of provider credentialing and payer enrollment experience.
• Experience with Medicare, Medicaid, and commercial insurance.
• Knowledge of CAQH management and regulatory requirements.
• Strong written and verbal communication.

Responsibilities

• Complete initial and recredentialing applications for providers.
• Maintain credentialing files and documentation.
• Enroll providers with Medicaid and other payers.
• Monitor status and follow up with payers.
• Manage CAQH profiles and required attestations.
• Coordinate onboarding activities and audits.

Skills

Organizational skills

Attention to detail

Time management

Communication skills

Multitasking

Independent and collaborative

Education

Associate's Degree

Bachelor's Degree

Tools

CAQH

PECOS

Insurance payer portals

Monday.com

Job description

Ezra Medical Center is a trusted, multi-specialty healthcare provider proudly serving the Brooklyn community for over 18 years. With a commitment to compassionate, high-quality care, our services span across:

• Internal Medicine & Pediatrics
• Aqua and Physical Therapy
• Vision Center

Learn more about us at: www.ezramedical.org

Position Overview

We are seeking an experienced, highly organized, and detail-oriented Credentialing Specialist to join our growing team at Ezra Medical Center. This position plays a critical role in ensuring healthcare providers are properly credentialed, enrolled, and maintained with Medicare, Medicaid, and commercial insurance carriers. The ideal candidate will possess strong knowledge of credentialing processes, payer enrollment requirements, CAQH management, and regulatory compliance while maintaining excellent communication with providers, payers, and internal stakeholders.

The successful candidate will utilize Monday.com to manage credentialing workflows, monitor application progress, coordinate provider onboarding activities, and ensure timely completion of all credentialing requirements.

Key Responsibilities

Provider Credentialing

• Complete and submit initial credentialing and recredentialing applications for healthcare providers.
• Medical licenses
• DEA registrations
• Board certifications
• Education and training
• Employment history
• Malpractice insurance coverage
• Maintain accurate and complete provider credentialing files and documentation.
• Enroll providers with:
• Medicaid
• Monitor application status and proactively follow up with payers to ensure timely approvals.
• Manage provider additions, updates, and terminations with insurance carriers.

CAQH Management

• Maintain and update provider profiles within CAQH.
• Ensure all supporting documentation remains current and properly attested according to required timelines.

Compliance & Monitoring

• Track expiration dates for licenses, certifications, malpractice insurance, and other provider credentials.
• Conduct routine audits to ensure credentialing files remain accurate and compliant.
• Stay informed of changes in credentialing regulations, payer requirements, and industry best practices.

Provider Support

• Serve as the primary point of contact for providers regarding credentialing and enrollment inquiries.
• Assist providers with obtaining, renewing, and maintaining required credentials.

Recordkeeping & Reporting

• Maintain credentialing databases, tracking systems, and provider records.
• Generate reports related to credentialing status, enrollment progress, and upcoming expirations.
• Ensure all documentation is organized, complete, and audit-ready.
• Partner closely with:
• Human Resources
• Medical Staff Offices
• Practice Managers
• Revenue Cycle and Billing Teams
• Insurance Representatives
• Coordinate provider onboarding activities to prevent delays in patient care and reimbursement.

Qualifications

Education

• Associate's Degree, Bachelor's Degree, or equivalent professional experience preferred.

Experience

• Minimum of 3 years of provider credentialing and payer enrollment experience required.
• Experience working with Medicare, Medicaid, and commercial insurance credentialing processes.

Technical Skills

• CAQH
• PECOS
• Insurance payer portals
• Monday.com or similar project management software
• Strong knowledge of credentialing workflows and regulatory requirements.

Core Competencies

• Exceptional organizational and time-management skills.
• Strong attention to detail and follow-through.
• Ability to manage multiple providers and credentialing projects simultaneously.
• Excellent written and verbal communication skills.
• Ability to work independently and collaboratively in a fast-paced healthcare environment.

As a full-time team member at Ezra Medical Center, you'll receive a comprehensive benefits package, including:

• 401(k)
• Disability Insurance
• Health Insurance
• Life Insurance
• Paid Time Off
• Vision Insurance

Work Location: 1312 38th Street Brooklyn, NY 11218

COVID-19 Protocols: PPE provided, temperature checks, and social distancing protocols in place as needed.