Hybrid Healthcare Credentialing Specialist

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

Job summary

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

The role maintains credentialing files, tracks renewals, manages CAQH and NPI profiles, submits payer applications, generates leadership reports and supports audits in a collaborative, trauma‑informed environment.

Qualifications

• Experience in credentialing and provider enrollment.
• Knowledge of NCQA, CMS, and state regulations preferred.
• Attention to detail and ability to manage multiple records

Responsibilities

• Collect, verify, and process provider documentation (licenses, certifications, education, work history, malpractice history).
• Submit applications to insurance payers and monitor approval status.
• Maintain accurate 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 and notify providers of renewals.
• Verify renewal information and update credentialing files.
• Maintain credentialing database and provider records with high accuracy.
• Generate reports for leadership and assist with audits as needed.
• Maintain CAQH and NPI profiles for providers.
• Serve as liaison between providers, insurance companies, and internal departments.
• Perform other duties as assigned

Skills

Medical credentialing

Provider enrollment

Education

High School Diploma or GED

Associate's degree in healthcare administration or related field

Job description

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

The role maintains credentialing files, tracks renewals, manages CAQH and NPI profiles, submits payer applications, generates leadership reports and supports audits in a collaborative, trauma‑informed environment.