Credentialing Specialist (FULL TIME - 8 HOURS)

Clarity Works is seeking an experienced Credentialing Specialist to manage the full credentialing lifecycle for healthcare providers and practices.

This is a full-time, 8-hour-per-day role. The ideal candidate is highly organized, proactive, persistent, and experienced managing credentialing, payer enrollment, provider maintenance, and ongoing compliance across multiple clients.

TO APPLY

Please submit your resume and a brief summary of your credentialing experience. Applicants without direct credentialing and payer enrollment experience will not be considered.

Key Responsibilities

• Manage the full credentialing lifecycle for individual providers, groups, and facilities
• Complete commercial payer, Medicare, Medicaid, and other network enrollment applications
• Maintain and update CAQH profiles, including required reattestations and supporting documents
• Manage PECOS, NPPES, NPI Type 1 and Type 2 registrations, updates, and revalidations
• Monitor licenses, DEA, malpractice insurance, board certifications, and other expiring credentials
• Handle recredentialing, revalidation, demographic updates, provider additions, terminations, and roster changes
• Complete and monitor EFT and ERA enrollments
• Track payer applications through approval, effective date, and final system loading
• Verify providers are correctly loaded into payer systems, networks, and directories
• Monitor payer panel status and network participation
• Follow up consistently with payers by phone, portal, and email to move applications forward and resolve delays
• Contact providers and practice staff directly to obtain missing documents, signatures, attestations, and other required information
• Escalate stalled applications and resolve rejections, discrepancies, missing information, and payer enrollment issues
• Maintain accurate credentialing trackers with submission dates, reference numbers, status, effective dates, next follow-up dates, and outstanding items
• Maintain organized records of applications, approvals, correspondence, confirmations, and payer documentation
• Send clear weekly credentialing status reports to clients
• Communicate delays, risks, missing items, and action steps clearly to clients and internal teams
• Monitor upcoming renewals, reattestations, revalidations, and expirations to prevent lapses in participation
• Help protect revenue by identifying credentialing issues that may affect claim submission, effective dates, or reimbursement

Qualifications

• 2+ years of hands-on provider credentialing and payer enrollment experience
• Strong experience with CAQH, PECOS, NPPES, Availity, Medicare, Medicaid, and commercial payer portals
• Experience credentialing individual providers, groups, and multi-provider practices
• Strong understanding of credentialing, recredentialing, revalidation, payer enrollment, rosters, EFT/ERA, panel status, and effective-date workflows
• Comfortable calling providers and payers directly and persistently following up until issues are resolved
• Strong organization, documentation, follow-up, and problem-solving skills
• Ability to independently manage multiple clients, providers, and applications at the same time
• Strong written and verbal communication skills
• Experience with behavioral health, mental health, primary care, multi-specialty, or multi-provider organizations is a plus

The right candidate will take ownership of credentialing from initial onboarding through ongoing maintenance, monitoring, reattestation, recredentialing, renewals, and payer follow-up.