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Credentialing Specialist

$26 - $29 per hour

Addison Group

Job DescriptionJob DescriptionTitle: Credentialing SpecialistLocation: Wilmington, NCCompensation: $26.00 - $29.00 per hourBenefits: This position may be eligible for medical, dental, vision, and 401(k) benefits through Addison Group during the contract period.About the OpportunityAddison Group is seeking a Credentialing Specialist on behalf of our client for a contract-to-hire opportunity within a growing healthcare organization. This newly created role will serve as the primary owner of provider credentialing, payer enrollment, and licensing processes across a multi-provider practice. This is an exciting opportunity for an experienced credentialing professional who enjoys building processes, improving workflows, and serving as the go-to resource for provider enrollment activities. The ideal candidate will be comfortable working independently while collaborating closely with providers, operations, and revenue cycle teams.Key Responsibilities• Manage the full lifecycle of provider credentialing, recredentialing, and enrollment activities• Coordinate provider enrollment with commercial, government, and managed care payers• Maintain provider records, licenses, certifications, and credentialing documentation• Serve as the primary point of contact for provider enrollment and credentialing inquiries• Process and monitor applications through payer portals and regulatory systems• Manage provider participation with government and commercial programs, including state and federal enrollment platforms• Coordinate hospital privilege applications, renewals, and supporting documentation• Track application status, follow up on outstanding items, and ensure timely completion of enrollment activities• Develop and maintain credentialing workflows, tracking tools, and documentation procedures• Collaborate with providers, revenue cycle teams, and practice leadership to resolve enrollment issues• Ensure compliance with payer requirements, accreditation standards, and organizational policies• Identify opportunities to improve credentialing efficiency and streamline processes as the department growsRequirements• Minimum of 3 years of provider credentialing and payer enrollment experience• Strong understanding of the complete credentialing lifecycle, including licensing, enrollment, recredentialing, and hospital privileges• Experience managing provider enrollment with multiple commercial and government payers• Hands-on experience with NCTracks required• Familiarity with CAQH, PECOS, and other provider enrollment platforms• Strong organizational skills with the ability to manage multiple providers and deadlines simultaneously• Excellent attention to detail and documentation accuracy• Strong written and verbal communication skills• Ability to work independently with minimal supervision• Comfort communicating directly with providers, leadership, and payer representativesPreferred Qualifications• Credentialing certification (CPCS, CPMSM, or equivalent)• Experience supporting hospice, palliative care, or physician practice environments• Experience building credentialing processes or working in a newly created function• Knowledge of provider enrollment across North Carolina and South Carolina• Experience working collaboratively with revenue cycle and practice operations teamsWhy Apply?• Opportunity to own and shape a credentialing function from the ground up• Strong visibility with leadership and providers• Flexible work environment with hybrid potential• Growing healthcare organization with expanding provider network• Ability to make a meaningful impact on operational efficiency and provider onboardingAddison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.#HC5

Vacancy posted 3 days ago
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