Credentialing Specialist

3+ years of direct experience in provider enrollment and credentialing. Extensive experience working with PECOS enrollments, I&A, and request for corrections. Prior work with Medicare Advantage health plans and credentialing requirements. Comfortable learning and using tools such as Airtable, credentialing automation software, and common office/productivity apps. Impeccable attention to detail, organization, and ability to meet deadlines. Experience building SOPs and improving operational workflows. Able to work cross-functionally and communicate clearly.

Manage the full credentialing lifecycle for providers and practice locations, including Medicare (PECOS), Medicare Advantage plans, and other payers. Ensure CAQH profiles are complete, current, and accurately reflect provider credentials and practice information. Assess current credentialing processes, identify inefficiencies, and implement improvements using Airtable, automation tools, and best practices. Write, maintain, and iterate standard operating procedures for credentialing functions. Track credentialing status, re-credentialing deadlines, notices, and plan requirements. Partner with internal stakeholders to align priorities and share updates on credentialing progress. Serve as a credentialing point of contact for providers and internal teams.