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Credentialing Specialist Lead

The Dermatology Specialists

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Location:
United States, Long Island City

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Category:
Health and Beauty

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Contract Type:
Not provided

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Salary:

30.00 - 32.00 USD / Hour

Job Description:

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
  • experience with eClinicalWorks a plus

Additional Information:

Job Posted:
December 12, 2025

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