Credentialing Specialist I – Pediatric Care

Cure 4 The Kids Foundation; Las Vegas (NV); On-site; USD 48,000 - 72,000; Full time

Benefits offered by this job

Competitive compensation

Comprehensive benefits

Modern workplace

Job summary

Cure 4 The Kids Foundation is seeking a Credentialing Specialist I to coordinate credentialing, privileging, re-credentialing, and payer enrollment for providers in our Las Vegas clinic. This full-time role requires attention to detail and strong collaboration with physicians and staff.

The successful candidate will maintain CAQH profiles, monitor licenses, and ensure accurate, survey-ready files, while contributing to a fast-paced, mission-driven team serving children and families.

Qualifications

• High school diploma or GED.
• Minimum of two years of provider credentialing or medical staff services experience with primary source verification and license tracking.
• CPCS certification is preferred.
• Experience with CAQH, Joint Commission standards, and payer enrollment.
• Familiarity with credentialing databases and practice management software.

Responsibilities

• Manage internal and external provider credentialing, privileging, and re-credentialing to completion.
• Complete payer enrollment, revalidation, and updates for all providers, including CAQH profiles.
• Maintain current copies of state licenses, DEA certificates, malpractice coverage, and renewals.
• Conduct license monitoring and primary source verification.
• Perform primary source verification and sanctions checks.
• Review credentialing files for completeness and escalate issues as needed.
• Create and maintain credentialing binders and ensure online databases are updated.
• Coordinate with health plans, payer portals, and facilities for current information.
• Update credentialing information in practice management software and notify relevant staff.
• Support accreditation readiness efforts and process improvements, including AI tooling.
• Perform other duties as assigned.

Skills

Interpersonal skills

Communication skills

Attention to detail

Independent worker

Organizational skills

Education

High school diploma or GED

Job description

Cure 4 The Kids Foundation is seeking a Credentialing Specialist I to coordinate credentialing, privileging, re-credentialing, and payer enrollment for providers in our Las Vegas clinic. This full-time role requires attention to detail and strong collaboration with physicians and staff.

The successful candidate will maintain CAQH profiles, monitor licenses, and ensure accurate, survey-ready files, while contributing to a fast-paced, mission-driven team serving children and families.