Credentialing Specialist

Credentialing Execution:

• Manage end-to-end credentialing and re-credentialing for all clinicians across contracted payors.
• Ensure clinician credentials are current and verified to support audit readiness at any time.
• Coordinate with HR, Training, Clinical, and Scheduling to prevent credential status from blocking clinician start dates.

Payor Relationships & Escalation:

• Build relationships with payor credentialing departments and maintain proactive follow-up.
• Track payor-specific patterns to drive process changes and maintain a credentialing matrix.

Data, Tracking & Reporting:

• Maintain a live credentialing tracking system for real-time visibility into all active applications.
• Define and track key credentialing KPIs to support staffing and revenue forecasting.
• Use data to surface root causes of delays and demonstrate improvements over time.