Credentialing Specialist — Growth, Impact & Benefits

One GI; Forest Hill (TN); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Excellent paid time off

401(k) plan with employer match

Education reimbursement opportunities

Internal growth opportunities

Competitive health and supplemental…

Refer a friend bonus

Job summary

One GI is seeking a Credentialing Specialist to review credentialing and enrollment applications and perform primary source verifications. The role requires attention to detail and experience with CAQH, NPDB, Availity and related portals.

Join a team focused on high standards of compliance and patient care, with opportunities for professional growth and a strong benefits package. This on-site role supports various provider networks and health plans.

Qualifications

• High School Diploma or equivalent required.
• Minimum of two (2) years focused provider credentialing or provider enrollment experience.
• Working knowledge of Provider Enrollment portals including CAQH, NPDB, Identity & Access Management, NPPES, PECOS, and Availity.
• Experience in performing primary data source verifications.
• Specific knowledge of provider credentialing and payer enrollment process.

Responsibilities

• Review and screen initial and reappointment credentialing applications for completeness, accuracy, and compliance with regulations and standards.
• Conduct primary source verification and validate documentation for accuracy.
• Identify and resolve information gaps that could affect credentialing and enrollment.
• Maintain knowledge of current health plan and agency requirements for credentialing providers.
• Track license and certification expirations and assist in renewals and DEA registrations when needed.
• Assist in securing and maintaining enrollment with contracted plans.

Skills

Credentialing knowledge

Primary source verification

Attention to detail

Communication

Education

High School

Tools

CAQH

NPDB

Identity & Access Management

NPPES

PECOS

Availity

Job description

One GI is seeking a Credentialing Specialist to review credentialing and enrollment applications and perform primary source verifications. The role requires attention to detail and experience with CAQH, NPDB, Availity and related portals.

Join a team focused on high standards of compliance and patient care, with opportunities for professional growth and a strong benefits package. This on-site role supports various provider networks and health plans.