Credentialing Specialist

Comprehensive Benefits including medical, dental, vision, life insurance, disability, legal services, pet insurance & more. Monday to Friday | Tempe, AZ 85288 (onsite) Position Overview The Credentialing Specialist plays a critical role in supporting revenue cycle operations by ensuring healthcare providers are properly enrolled with governmental and commercial payers. This position is responsible for managing the end-to-end enrollment process, including application submission, payer communication, and ongoing maintenance to ensure timely and accurate claim reimbursement. This is a detail-oriented, high-volume role requiring strong organizational skills, the ability to navigate payer systems, and a proactive approach to problem-solving. Responsibilities Manage the full lifecycle of provider enrollment, including new enrollments, updates, and revalidations with Medicare, Medicaid, and commercial payers Coordinate and support electronic setup processes, including EDI (claims submission), EFT (payments), and ERA (remittance advice) Ensure all enrollment applications are complete, accurate, and compliant prior to submission, including obtaining required signatures and documentation Serve as a primary liaison to payers for enrollment status, troubleshooting, and issue resolution Monitor payer portals, enrollment processes, and document transmissions to track progress and resolve delays Track and maintain internal records, including licenses and enrollment data, to ensure consistency and audit readiness Support audits and quality checks related to provider enrollment and compliance Qualifications High school diploma or GED required Minimum of 3 years of provider enrollment, credentialing, or related healthcare experience required Experience working with governmental and commercial payers (Medicare, Medicaid, etc.) Familiarity with EDI, EFT, and ERA processes is a plus Strong attention to detail with the ability to manage high-volume, deadline-driven work Excellent communication and interpersonal skills, particularly when working with external payer representatives Proficiency in Microsoft Office (Word, Excel, Outlook) Ability to prioritize tasks independently and adapt to changing regulatory requirements Equal Opportunity Employer/Veterans/Disabled The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: The California Fair Chance Act Los Angeles City Fair Chance Ordinance Los Angeles County Fair Chance Ordinance for Employers #J-18808-Ljbffr LHH