Managing delegated credentialing activities, the full-time Credentialing Specialist will oversee payer audits, compliance reporting, and provider-data reconciliation while working remotely. Key responsibilities Oversee delegated credentialing activities for assigned payer portfolios, including audits and compliance monitoring Prepare and facilitate credentialing audits, developing corrective action plans as necessary Lead the credentialing process for Nurse Practitioners and group practices, ensuring accurate documentation and timely submissions Required qualifications 2-5 years of credentialing and enrollment experience, with at least 2 years focused on delegated credentialing Certified Provider Credentialing Specialist (CPCS) certification Ability to manage multiple payer relationships with minimal oversight Experience in high-growth or tech-enabled healthcare settings; behavioral health experience preferred Familiarity with credentialing software and payer rostering tools
Credentialing Specialist • Bayamon, Puerto Rico, United States
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