Onboarding Credentialing Specialist, Healthcare & Payer Enrollment
Overview
Own onboarding and credentialing for physicians and advanced practice providers at a multi-site healthcare organization. Scale onboarding, credentialing, recredentialing, and payer enrollment to ensure timely start dates. Partner with HR, operations, and leadership to maintain compliant records and audit readiness. This role stands out through hands-on provider credentialing in a complex clinical setting and mastery of Medicare, Medicaid, and commercial payer processes.
What You'll Do7
- 1Build onboarding workflows for newly hired providers from offer to start date
- 2Coordinate initial credentialing, recredentialing, and payer enrollment to avoid delays
- 3Maintain CAQH profiles and credentialing databases to ensure accurate provider data
- 4Track licenses, DEA registrations, board certifications, malpractice coverage, and credential expirations
- 5Work with HR, operations, finance, and leadership to support onboarding and stay aligned with regulatory requirements
- 6Identify opportunities to improve onboarding and credentialing processes and implement improvements
- 7Maintain accurate credentialing records and prepare documentation for audits
Requirements9
- 13+ years of provider credentialing and onboarding experience
- 2Experience credentialing physicians, nurse practitioners, physician assistants, or other licensed providers
- 3Strong knowledge of Medicare, Medicaid, CAQH, NPPES, PECOS, and commercial payer enrollment
- 4Experience managing initial credentialing, recredentialing, and privileging processes
- 5Familiarity with New York provider licensing and regulatory requirements
- 6Strong organizational and follow-up skills
- 7Ability to manage multiple providers and deadlines simultaneously
- 8Proficiency with Microsoft Office and credentialing software or provider databases
- 9Experience in a multi-site healthcare organization
Salary Insight
Salary not disclosed in listing
Location
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