Hybrid Credentialing & Compliance Specialist

WellPower - All Jobs; Denver (CO); Hybrid; USD 58,000 - 81,000; Full time

Job summary

WellPower is seeking a Credentialing Coordinator to manage credentialing and re-credentialing for healthcare providers, interns, residents and volunteers, ensuring compliance with NCQA, CMS, HRSA and state regulations.

This is a full-time, hybrid position in the Greater Denver Metro area. The role entails processing documentation, maintaining files, and partnering with payers and internal teams to support credentialing activities.

Qualifications

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

Responsibilities

• Collect, verify, and process provider documentation (licenses, certifications, education, work history, malpractice).
• Submit applications to insurance payers and monitor approval status.
• Maintain credentialing files in compliance with NCQA, HRSA, CMS, and state regulations.
• Track expiration dates and notify providers of renewals.
• Maintain CAQH and NPI profiles.
• Serve as liaison between providers, insurance companies, and internal departments.
• Generate reports for leadership and assist with audits.

Skills

Credentialing

Education

High School Diploma or GED

Associate’s degree in healthcare administration

Job description

WellPower is seeking a Credentialing Coordinator to manage credentialing and re-credentialing for healthcare providers, interns, residents and volunteers, ensuring compliance with NCQA, CMS, HRSA and state regulations.

This is a full-time, hybrid position in the Greater Denver Metro area. The role entails processing documentation, maintaining files, and partnering with payers and internal teams to support credentialing activities.