Credentialing Specialist

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 Our mission is to inspire and empower the lives we touch, to serve our communities, and to lead with purpose-driven passion. 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. 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. 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. 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. Perform other projects and duties as assigned. High school diploma or equivalent experience. Proficiency in Microsoft Office applications, including Word and Excel, Adobe Acrobat, and web-based systems. Previous experience with healthcare credentialing, provider enrollment, revenue cycle operations, or other healthcare administrative functions. Opportunities to stretch your skills—whether you’re building pipelines, designing sourcing strategies, or advising leadership. 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
• Generous PTO and paid holidays
• 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.

Benefits and eligibility are dependent on employment status and pay class (full-time, part-time, or PRN). Follow @Lifeatupstream on Instagram, and check out our LinkedIn company page to learn more about what it’s like to be part of the #upstreamfamily. LI-Remote 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.