Credentialing Specialist

About Ezra Medical CenterEzra Medical Center is a trusted, multi-specialty healthcare provider proudly serving the Brooklyn community for over 18 years. With a commitment to compassionate, high-quality care, our services span across:Internal Medicine & PediatricsDental ClinicAqua and Physical TherapyVision CenterTake the next step in your career now, scroll down to read the full role description and make your application.Learn more about us at: OverviewWe are seeking an experienced, highly organized, and detail-oriented Credentialing Specialist to join our growing team at Ezra Medical Center. This position plays a critical role in ensuring healthcare providers are properly credentialed, enrolled, and maintained with Medicare, Medicaid, and commercial insurance carriers. The ideal candidate will possess strong knowledge of credentialing processes, payer enrollment requirements, CAQH management, and regulatory compliance while maintaining excellent communication with providers, payers, and internal stakeholders.The successful candidate will utilize to manage credentialing workflows, monitor application progress, coordinate provider onboarding activities, and ensure timely completion of all credentialing requirements.Key ResponsibilitiesProvider CredentialingComplete and submit initial credentialing and recredentialing applications for healthcare providers.Verify provider qualifications, including:Medical licensesDEA registrationsBoard certificationsEducation and trainingEmployment historyMalpractice insurance coverageMaintain accurate and complete provider credentialing files and documentation.Payer EnrollmentEnroll providers with:MedicareMedicaidCommercial insurance carriersMonitor application status and proactively follow up with payers to ensure timely approvals.Manage provider additions, updates, and terminations with insurance carriers.CAQH ManagementMaintain and update provider profiles within CAQH.Ensure all supporting documentation remains current and properly attested according to required timelines.Compliance & MonitoringTrack expiration dates for licenses, certifications, malpractice insurance, and other provider credentials.Conduct routine audits to ensure credentialing files remain accurate and compliant.Stay informed of changes in credentialing regulations, payer requirements, and industry best practices.Provider SupportServe as the primary point of contact for providers regarding credentialing and enrollment inquiries.Assist providers with obtaining, renewing, and maintaining required credentials.Recordkeeping & ReportingMaintain credentialing databases, tracking systems, and provider records.Generate reports related to credentialing status, enrollment progress, and upcoming expirations.Ensure all documentation is organized, complete, and audit-ready.CollaborationPartner closely with:Human ResourcesMedical Staff OfficesPractice ManagersRevenue Cycle and Billing TeamsInsurance RepresentativesCoordinate provider onboarding activities to prevent delays in patient care and reimbursement.QualificationsEducationAssociate's Degree, Bachelor's Degree, or equivalent professional experience preferred.ExperienceMinimum of 3 years of provider credentialing and payer enrollment experience required.Experience working with Medicare, Medicaid, and commercial insurance credentialing processes.Technical SkillsCAQHPECOSInsurance payer portals or similar project management softwareStrong knowledge of credentialing workflows and regulatory requirements.Core CompetenciesExceptional organizational and time-management skills.Strong attention to detail and follow-through.Ability to manage multiple providers and credentialing projects simultaneously.Excellent written and verbal communication skills.Ability to work independently and collaboratively in a fast-paced healthcare environment.BenefitsAs a full-time team member at Ezra Medical Center, you'll receive a comprehensive benefits package, including:401(k)Dental InsuranceDisability InsuranceHealth InsuranceLife InsurancePaid Time OffVision InsuranceAdditional DetailsWork Location: 1312 38th Street Brooklyn, NY 11218COVID-19 Protocols: PPE provided, temperature checks, and social distancing protocols in place as needed. xhyhwjd Apply TodayAre you an experienced credentialing professional looking to make an impact in a mission-driven healthcare organization?Join Ezra Medical Center as our next Provider Credentialing Specialist and help ensure our providers can deliver exceptional patient care through efficient credentialing, enrollment, and compliance management