Credentialing Specialist

About Ezra Medical Center

Ezra 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 & Pediatrics
• Dental Clinic
• Aqua and Physical Therapy
• Vision Center

Learn more about us at:

Position Overview

We 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 Monday.com to manage credentialing workflows, monitor application progress, coordinate provider onboarding activities, and ensure timely completion of all credentialing requirements.

Key Responsibilities

Provider Credentialing

• Complete and submit initial credentialing and recredentialing applications for healthcare providers.
• Verify provider qualifications, including:
• Medical licenses
• DEA registrations
• Board certifications
• Education and training
• Employment history
• Malpractice insurance coverage
• Maintain accurate and complete provider credentialing files and documentation.

Payer Enrollment

• Enroll providers with:
• Medicare
• Medicaid
• Commercial insurance carriers
• Monitor application status and proactively follow up with payers to ensure timely approvals.
• Manage provider additions, updates, and terminations with insurance carriers.

CAQH Management

• Maintain and update provider profiles within CAQH.
• Ensure all supporting documentation remains current and properly attested according to required timelines.

Compliance & Monitoring

• Track 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 Support

• Serve as the primary point of contact for providers regarding credentialing and enrollment inquiries.
• Assist providers with obtaining, renewing, and maintaining required credentials.

Recordkeeping & Reporting

• Maintain 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.

Collaboration

• Partner closely with:
• Human Resources
• Medical Staff Offices
• Practice Managers
• Revenue Cycle and Billing Teams
• Insurance Representatives
• Coordinate provider onboarding activities to prevent delays in patient care and reimbursement.

Qualifications

Education

• Associate's Degree, Bachelor's Degree, or equivalent professional experience preferred.

Experience

• Minimum of 3 years of provider credentialing and payer enrollment experience required.
• Experience working with Medicare, Medicaid, and commercial insurance credentialing processes.

Technical Skills

• CAQH
• PECOS
• Insurance payer portals
• Monday.com or similar project management software
• Strong knowledge of credentialing workflows and regulatory requirements.

Core Competencies

• Exceptional 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.

Benefits

As a full-time team member at Ezra Medical Center, you'll receive a comprehensive benefits package, including:

• 401(k)
• Dental Insurance
• Disability Insurance
• Health Insurance
• Life Insurance
• Paid Time Off
• Vision Insurance

Additional Details

Work Location: th Street Brooklyn, NY 11218

COVID-19 Protocols: PPE provided, temperature checks, and social distancing protocols in place as needed.

Apply Today

Are 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