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The Credentialing Specialist Lead serves as the senior subject matter expert within our credentialing team, overseeing the end-to-end credentialing and re-credentialing process for all providers across The Dermatology Specialists. This position ensures compliance with payer and regulatory requirements while supporting process improvement and mentoring other team members.
Job Responsibility:
Manage the full credentialing lifecycle for physicians, NPs, and PAs — including Medicaid, Medicare, and commercial payer enrollments (Empire BCBS, Fidelis, Aetna, etc.)
Review and verify provider documents such as medical licenses, DEA, board certifications, malpractice coverage, and CVs
Prepare, track, and submit enrollment applications accurately and within payer timelines
Monitor revalidation and re-credentialing schedules to ensure ongoing compliance
Serve as the primary point of contact for escalated payer or provider inquiries
Partner with internal billing and operations teams to ensure credentialing aligns with billing readiness
Maintain credentialing logs, dashboards, and internal trackers for reporting purposes
Assist in training and supporting new credentialing specialists, ensuring quality and consistency across workflows
Requirements:
3+ years of healthcare credentialing experience
dermatology or multispecialty experience preferred
Strong knowledge of CAQH, NPPES, Medicaid, Medicare, and commercial payer portals
Exceptional attention to detail, organization, and follow-through
Excellent communication and interpersonal skills
Proficiency in Excel and credentialing systems
experience with eClinicalWorks a plus
Nice to have:
dermatology or multispecialty experience preferred
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