Credentialing Specialist
We are seeking a Credentialing Specialist for a temporary contract assignment with one of our clients in Albany, NY. This is a short-term, contract role. Key responsibilities include maintaining an accurate and up-to-date credentialing database and Smartsheet tracker with reminders for all regulatory and agency-required positions. Work with internal staff, independent contractors, and representatives from commercial insurers and entitlement programs to complete credentialing requirements. Prepare credentialing packets, provide documentation checklists, and schedule credentialing meetings as needed. Complete credentialing and re-credentialing applications for commercial payers and government programs. File appropriate rosters with facility-based insurers and plans. Track and maintain credentialing status by individual provider/license, including all active, pending, and closed applications across locations and programs. Provide weekly credentialing status reports to the CFO for executive review. Monitor and track provider license and credential expiration dates; send timely reminders for renewal. Ensure provider profiles are current across all credentialing platforms including CAQH, PECOS, NPPES, and CMS databases. Complete revalidation requests from government payers in collaboration with program leadership. Serve as the primary liaison for credentialing activities with external billing partners. Ensure compliance with all credentialing-related regulatory and accrediting requirements. Support continuous improvement of credentialing workflows and compliance procedures.
Requirements: High School Diploma with at least 5 years of credentialing experience, or a Bachelor's Degree with at least 3 years of experience in credentialing. Strong knowledge of provider credentialing processes, documentation requirements, and payer-specific systems (commercial and government). Proficiency in using credentialing systems and databases, with excellent organizational and communication skills.