Credentialing Specialist - Elevate Provider Enrollment

One GI, LLC; Germantown (TN); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Paid time off

401(k) with employer match

Education reimbursement

Internal growth opportunities

Health benefits

FSA/HSA options

Referral bonus

Job summary

One GI, LLC is seeking a Credentialing Specialist to join our team in Germantown, TN. The ideal candidate brings strong credentialing knowledge, attention to detail, and a commitment to accurate, timely provider enrollment and credentialing.

You will review applications, perform primary source verifications, and monitor license/certification renewals while coordinating with payers and facilities to ensure compliant enrollment.

Qualifications

• Minimum of two years focused provider credentialing or provider enrollment experience.
• Experience in performing primary data source verifications.
• Knowledge of provider credentialing portals including CAQH, NPDB, Identity & Access Management, NPPES, PECOS, and Availity.
• Familiarity with HIPAA and healthcare regulations.

Responsibilities

• Review and screen credentialing applications for completeness, accuracy, and compliance with regulations and standards.
• Conduct primary source verification and collect/validate documents.
• Track license and certification expirations and assist in renewals.
• Assist in securing and maintaining enrollment with contracted and new payer plans.

Skills

Credentialing

Primary source verification

Regulatory compliance

Attention to detail

Communication

Enrollment processes

Education

High School Diploma or equivalent

Tools

CAQH

NPDB

NPPES

PECOS

Availity

Job description

One GI, LLC is seeking a Credentialing Specialist to join our team in Germantown, TN. The ideal candidate brings strong credentialing knowledge, attention to detail, and a commitment to accurate, timely provider enrollment and credentialing.

You will review applications, perform primary source verifications, and monitor license/certification renewals while coordinating with payers and facilities to ensure compliant enrollment.