Credentialing Specialist

Unclassified; New York (NY); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Holidays

Growth opportunities

Job summary

Brooklyn-based healthcare organization is seeking a detail-oriented Provider Credentialing Specialist to manage credentialing, recredentialing, and payer enrollment, ensuring compliance and timely onboarding for providers.

You will verify licenses, DEA, certifications, and education, maintain CAQH profiles, and track expirations, collaborating with Medicare, Medicaid, and commercial payers. Monday.com will be used to manage workflows.

Qualifications

• Credentialing and payer enrollment experience preferred.
• Experience with Medicare, Medicaid, and commercial insurance.
• Proficiency in CAQH, PECOS, and payer portals.

Responsibilities

• Manage full-cycle credentialing and recredentialing processes.
• Complete and submit credentialing and payer enrollment applications.
• Verify provider credentials (licenses, DEA, certifications, education, work history).
• Maintain credentialing files and ensure documentation accuracy.
• Enroll providers with Medicare, Medicaid, and commercial payers.
• Track applications and follow up with insurance carriers.
• Maintain CAQH profiles and ensure timely attestations.
• Monitor expirations and ensure ongoing compliance.
• Use Monday.com to track workflows, deadlines, and onboarding.

Skills

Organizational skills

Multitasking

Independent work

CAQH/PECOS

Tools

CAQH/PECOS

Job description

Overview

Position Overview: A leading healthcare organization is seeking a highly organized and detail-oriented Provider Credentialing Specialist to manage credentialing, recredentialing, and payer enrollment. This role ensures compliance with regulatory and insurance requirements while supporting timely provider onboarding and uninterrupted reimbursement.

Responsibilities

• Manage full-cycle credentialing and recredentialing processes
• Complete and submit credentialing and payer enrollment applications
• Verify provider credentials (licenses, DEA, certifications, education, work history)
• Maintain credentialing files and ensure documentation accuracy
• Enroll providers with Medicare, Medicaid, and commercial payers
• Track applications and follow up with insurance carriers
• Maintain CAQH profiles and ensure timely attestations
• Monitor expirations and ensure ongoing compliance
• Use Monday.com to track workflows, deadlines, and onboarding

Qualifications

• Credentialing and payer enrollment experience preferred
• Experience with Medicare, Medicaid, and commercial insurance
• Proficiency in CAQH, PECOS, and payer portals
• Strong organizational and multitasking skills
• Ability to work independently with minimal training

Compensation & Benefits

Salary: $70,000 - $90,000+ (DOE)

Schedule: Monday-Thursday 9:00 AM-5:00 PM; Friday 9:00 AM-1:00 PM

• Health, dental, and vision insurance
• Paid time off and holidays
• Warm, team-oriented office environment
• Growth opportunities within the organization

About the Employer

This organization is a well-established healthcare provider in Brooklyn, committed to delivering high-quality patient care while maintaining operational excellence and compliance.