Credentialing Specialist

Desert Spine and Sports Physicians, PLLC

Phoenix (AZ)

Sur place

USD 42 000 - 68 000

Plein temps

Il y a 39 heures
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Avantages offerts par ce poste

Medical, dental, vision, and life_ins
401(k) match and paid time off
Exposure to multiple medical specialt
Opportunities to develop credentialing
Collaborative team environment

Résumé du poste

Desert Spine & Sports Physicians in Phoenix, AZ is seeking a Credentialing Specialist to manage provider credentialing and enrollment end-to-end. You will work closely with providers and internal teams to ensure readiness, accuracy, and timely submissions.

This role emphasizes ownership, proactive communication, and opportunities to streamline workflows, monitor expirations, and improve visibility into credentialing status as the practice grows.

Qualifications

  • At least 3 years healthcare credentialing and enrollment experience.
  • Proficiency with PDFs, Microsoft Word and Excel.
  • Strong oral and written communication skills; ability to interact with all levels.
  • Ability to prioritize, plan, and handle multiple tasks/demands simultaneously.

Responsabilités

  • Own: Provider credentialing, enrollment, and recredentialing from application through approval, maintaining visibility into provider status, outstanding requirements, and upcoming deadlines.
  • Teach: Help internal teams understand credentialing timelines and information needed to keep applications moving.
  • Develop and implement proactive renewal tracking and repeatable workflows to reduce delays.

Connaissances

Communication skills
Detail oriented
Prioritization

Outils

PDF
Microsoft Word
Excel

Description du poste

Credentialing Specialist

Desert Spine & Sports Physicians Phoenix, Arizona, United States

About this position

Description:

Desert Spine & Sports Physicians is a growing, multi-specialty medical practice, and we’re looking for a Credentialing Specialist who takes pride in keeping things organized, moving forward, and getting the details right. In this role, you’ll manage provider credentialing and enrollment, work through challenges with insurance payers, and help ensure our providers are ready to see patients. We’re looking for someone who takes ownership, communicates well, and looks for ways to make processes better as we continue to grow.

This person is someone we can count on to...

Own: Provider credentialing, enrollment, and recredentialing from application through approval, maintaining visibility into provider status, outstanding requirements, and upcoming deadlines.

Teach: Help internal teams understand credentialing timelines, provider readiness, and the information needed to keep applications moving. Establish clear communication and handoffs that reduce confusion and prevent avoidable delays.

Learn: Develop a thorough understanding of the organization's providers, specialties, payer relationships, current workflows, and credentialing requirements while identifying opportunities to strengthen the process.

Improve: Create consistent tracking, proactive renewal monitoring, and repeatable workflows that reduce preventable delays, improve visibility, and support the organization's continued growth.

Within...
1 month this person will:
  • Meet with key stakeholders and learn the current credentialing and provider enrollment processes.
  • Review provider files, payer applications, CAQH profiles, enrollment records, and upcoming expiration dates.
  • Identify outstanding applications, missing documentation, immediate risks, and upcoming deadlines.
  • Establish an initial inventory of provider credentialing status and prioritize urgent items requiring attention.
2 months this person will:
  • Complete a review of existing provider credentialing and enrollment records and identify gaps requiring resolution.
  • Establish baseline measures for application progress, internal processing timelines, outstanding requirements, and renewal tracking.
  • Develop a prioritized 30-60-90-day action plan identifying key issues, deadlines, follow-up expectations, and escalation procedures.
  • Implement a consistent tracking method that provides visibility into application status, payer participation, effective dates, and upcoming renewals.
3 months this person will:
  • Begin executing the action plan and address the highest-priority credentialing gaps and outstanding applications.
  • Establish a proactive process for monitoring provider expirations, recredentialing deadlines, and required documentation.
  • Provide regular updates on provider credentialing status, at-risk items, pending payer decisions, and resolution plans.
  • Establish a repeatable follow-up process that keeps applications moving and escalates delays before they create avoidable operational or reimbursement issues.
Potential Obstacles:
  • Different payer requirements, application processes, portals, and approval timelines.
  • Incomplete provider documentation or delays obtaining information from providers and external organizations.
  • Competing priorities between new provider enrollment, existing applications, recredentialing, and renewals.
  • Limited visibility into historical application status or inconsistent tracking methods.
  • External payer delays that are outside the organization's direct control but require consistent follow-up and escalation.
  • Continued organizational growth that increases credentialing volume and complexity.
Work Environment:

The Credentialing Specialist will work within a growing, multi-specialty medical practice and collaborate with Human Resources, practice leadership, providers, billing, and other operational teams. The role requires independent ownership of assigned work, consistent follow-through, proactive communication, and the ability to identify and resolve issues before they create larger problems.

Why Join Desert Spine & Sports Physicians?

At Desert Spine & Sports Physicians, every role plays a part in supporting our providers and the patients we serve. As our practice continues to grow, we're looking for people who take pride in their work, support their teammates, and want to make a difference. If you're looking for a role where you can build your skills, take ownership of your work, and grow with a supportive team, we'd love to meet you!

What We Offer
  • Medical, dental, vision, and life insurance benefits.
  • 401(k) match and paid time off.
  • Exposure to multiple medical specialties and insurance payer networks.
  • Opportunities to develop your expertise in credentialing and provider enrollment.
  • A collaborative team environment with opportunities for continued learning and career growth.
Our Core Values
  • Positive Attitude - Choosing optimism over negativity, energy instead of excuses, solutions instead of complaints.
  • Growth Mindset - Asking “How can I get better?” Mistakes aren’t failures when we learn; feedback isn’t criticism when it helps.
  • Help First - None of us wins alone. When someone is overwhelmed, we step in. We never say “that’s not my job.”
  • Do What's Right - Honest even when it’s uncomfortable. Our integrity is not negotiable, even when no one is watching.
  • Do What You Say - If you say you’re going to do it, do it. If circumstances change, communicate early.

If these values sound like you, we encourage you to apply and learn more about joining our team!

Requirements
  • At least 3 years healthcare credentialing and enrollment experience is required.
  • Computer skills to include PDF, Microsoft Word, Excel and basic data entry, including the ability to learn new and complex computer system applications.
  • Strong oral and written communication skills; ability to interact with all levels of internal and external contacts.
  • Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
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