Healthcare Credentialing Specialist

Talentify; Denver (CO); Hybrid; USD 58,000 - 81,000; Full time

Job summary

WellPower is seeking a Credentialing Coordinator in the Denver metro area to manage credentialing for providers, interns, residents, and volunteers, ensuring compliance with NCQA, CMS, HRSA, and state regulations.

The role maintains CAQH and NPI profiles, tracks expirations, and generates leadership reports while supporting a trauma-informed environment; it is a full-time, hybrid position with standard business hours.

Qualifications

• 2+ years of medical credentialing and/or provider enrollment experience.
• High School Diploma or GED required.
• Associate's degree in healthcare administration, business, or related field preferred.

Responsibilities

• Collect, verify, and process provider documentation including licenses, certifications, education, work history, and malpractice history.
• Submit applications to insurance payers and monitor approval status.
• Maintain accurate and up-to-date credentialing files in compliance with NCQA, HRSA, CMS, and state regulations.
• Ensure adherence to organizational policies, federal and state regulations, and accreditation standards.
• Track expiration dates for licenses, certifications, and other credentials; notify providers of upcoming renewals.
• Verify all renewal information and update the provider credentialing file
• Maintain credentialing database and provider records with high accuracy.
• Generate reports for leadership and assist with audits as needed.

Skills

Medical credentialing experience

Provider enrollment experience

Education

High School Diploma or GED

Associate's degree in healthcare administration, business, or related field

Job description

WellPower is seeking a Credentialing Coordinator in the Denver metro area to manage credentialing for providers, interns, residents, and volunteers, ensuring compliance with NCQA, CMS, HRSA, and state regulations.

The role maintains CAQH and NPI profiles, tracks expirations, and generates leadership reports while supporting a trauma-informed environment; it is a full-time, hybrid position with standard business hours.