Credentialing Specialist

Job Description

Preferred Therapy Partners, a Brand Partner of Upstream Rehabilitation, is looking for a Credentialing Specialist to join our team!

Credentialing Specialist

Location Type: Remote - Arizona

Must Reside in the United States

Build Your Career with Us!

Upstream Rehabilitation is the country's largest dedicated provider of outpatient physical and occupational therapy services. Our mission is to inspire and empower the lives we touch, to serve our communities, and to lead with purpose-driven passion. We are committed to delivering remarkable experiences and fostering an inclusive workplace where differences are valued and celebrated. With 1,200+ locations nationwide, 26 brand partners, and 8,000+ employees, Upstream operates at scale while leveraging data, technology, and innovation to drive smarter decisions and operational excellence across the organization.

Job Description

Preferred Therapy Partners, a Brand Partner of Upstream Rehabilitation, is looking for a Credentialing Specialist to join our team!

Credentialing Specialist

Location Type: Remote - Arizona

Must Reside in the United States

Build Your Career with Us!

Upstream Rehabilitation is the country's largest dedicated provider of outpatient physical and occupational therapy services. Our mission is to inspire and empower the lives we touch, to serve our communities, and to lead with purpose-driven passion. We are committed to delivering remarkable experiences and fostering an inclusive workplace where differences are valued and celebrated. With 1,200+ locations nationwide, 26 brand partners, and 8,000+ employees, Upstream operates at scale while leveraging data, technology, and innovation to drive smarter decisions and operational excellence across the organization.

The Role:

Join Preferred Therapy Providers, a brand partner of Upstream Rehabilitation, where your work makes a real impact! As a Credentialing Specialist, you will support the initial credentialing and recredentialing of practitioners within the Preferred Therapy Providers (PTP) network. This includes collecting and verifying practitioner information, conducting primary source verification, maintaining credentialing records, and coordinating with contracted health plans and internal and external stakeholders. In this role, you will ensure practitioner data remains accurate and up to date, monitor licensure and certification requirements, and support credentialing activities in compliance with applicable regulations, accreditation standards, and company policies. Your attention to detail and commitment to quality will play a critical role in maintaining a high-performing provider network while advancing PTP's mission, vision, and values and contributing to the organization's continued growth and success.

What You'll Do:

• Maintain accurate and timely practitioner data, electronic files, and credentialing records within the credentialing database, ensuring information is entered, updated, and revised as needed.
• Access and manage practitioner information through CAQH and paper application systems to support credentialing and recredentialing activities.
• Provide administrative support for credentialing operations.
• Perform primary source verifications and maintain practitioner licensing, credentialing, certification, and insurance records, ensuring all documentation is accurate, current, and complete.
• Monitor license, certification, insurance, and continuing education requirements; track expiration and renewal dates; and maintain compliance with applicable organizational, regulatory, and accreditation standards.
• Communicate with internal stakeholders and external practitioners regarding application status, credentialing requirements, and outstanding documentation to support the timely completion of credentialing and recredentialing activities.
• Perform credentialing and recredentialing activities in accordance with applicable federal and state regulations, payer requirements, accreditation standards, and company policies and procedures.
• Monitor credentialing files and outstanding requirements, proactively identifying and escalating delays, deficiencies, or compliance concerns as appropriate.
• Maintain the confidentiality, integrity, and security of practitioner information and credentialing records in accordance with company policies and applicable regulatory requirements.
• Crosstrain and provide support in other functional areas as needed.
• Perform other projects and duties as assigned.

Who You Are:

• High school diploma or equivalent experience.
• Strong attention to detail, self-motivation, and effective written and verbal communication skills.
• Demonstrated ability to establish and maintain positive working relationships with providers, leadership, staff, and external partners.
• Proficiency in Microsoft Office applications, including Word and Excel, Adobe Acrobat, and web-based systems.
• Proven ability to organize and prioritize work, manage multiple responsibilities, and meet deadlines in a fast-paced environment.

Nice to Haves:

• Previous experience with healthcare credentialing, provider enrollment, revenue cycle operations, or other healthcare administrative functions.
• Experience supporting healthcare organizations, including physical therapy, rehabilitation, or related clinical settings.

Why You'll Love Working Here

• The chance to directly shape our organization's growth by hiring the talent that drives our mission.
• Opportunities to stretch your skills-whether you're building pipelines, designing sourcing strategies, or advising leadership.
• A collaborative team environment where your ideas are valued.
• Competitive compensation, comprehensive benefits, and ongoing professional development.

Benefit Offerings:

• Annual paid Charity Day to give back to a cause meaningful to you
• 100% employer paid medical health insurance premium option available
• Dental and Vision insurance
• 401(k) with company match
• Generous PTO and paid holidays
• Supportive team and leadership invested in your success

A Better Place to Build Your Career

Upstream Rehabilitation offers meaningful opportunities across corporate and non-clinical roles, both remotely and in corporate offices nationwide. We invest in our people through leadership development programs, ongoing education, and professional growth opportunities. Our corporate teams are critical to Upstream's success - and to the culture that makes this a great place to work. You'll join a group of talented professionals who collaborate, innovate, and know how to have fun while making a real impact.

Salary Range: $17.31 - $23.08/hour

Estimated pay ranges listed above are based on several factors including but not limited to your pay class, experience, background and geographic location of the clinic

Benefits and eligibility are dependent on employment status and pay class (full-time, part-time, or PRN). Specific details will be provided during the hiring process.

Follow @Lifeatupstream on Instagram, and check out our LinkedIn company page to learn more about what's like to be part of the #upstreamfamily.

Upstream Rehabilitation is an Equal Opportunity Employer that strives to provide an inclusive work environment where our differences are celebrated for the value they bring to our communities, our patients and our teammates. Upstream Rehabilitation does not discriminate on the basis of race, color, national origin, religion, gender (including pregnancy), sexual orientation, age, disability, veteran status, or other status protected under applicable law.