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Credentialing Specialist

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Robert Half

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Location:
United States , Nashville

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Category:
Health and Beauty

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Contract Type:
Not provided

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Salary:

Not provided
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Job Description:

We are seeking a Credentialing Specialist for a short term contract in Nashville. This role is responsible for managing and maintaining provider credentials to ensure compliance with regulatory, accreditation, and payer requirements. This role supports timely provider onboarding, payer enrollment, and recredentialing while ensuring accuracy, confidentiality, and adherence to healthcare standards.

Job Responsibility:

  • Coordinate and process initial credentialing, recredentialing, and payer enrollment for healthcare providers
  • Collect, verify, and maintain provider documentation including licenses, certifications, education, training, work history, NPIs, and DEA registrations
  • Prepare and submit credentialing and enrollment applications to insurance payers, hospitals, and regulatory bodies
  • Monitor credential expirations and proactively manage renewals to maintain continuous provider eligibility
  • Maintain accurate and up‑to‑date credentialing records in credentialing software and internal databases
  • Serve as a liaison between providers, payers, medical staff offices, and internal departments
  • Track application statuses, follow up on outstanding items, and resolve credentialing or enrollment issues
  • Ensure compliance with CMS, NCQA, Joint Commission, state, and payer credentialing requirements
  • Support audits and accreditation reviews by preparing and providing credentialing documentation
  • Maintain strict confidentiality of sensitive provider information

Requirements:

  • High school diploma or equivalent (Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred)
  • 1–3 years of experience in healthcare credentialing, provider enrollment, or medical staff services
  • Knowledge of payer enrollment processes (Medicare, Medicaid, commercial payers)
  • Familiarity with credentialing standards and regulatory requirements
  • Proficiency with credentialing software, provider databases, and Microsoft Office (Excel, Word, Outlook)
  • Strong organizational skills with high attention to detail
  • Excellent written and verbal communication skills
What we offer:
  • medical
  • vision
  • dental
  • life and disability insurance
  • 401(k) plan

Additional Information:

Job Posted:
May 05, 2026

Work Type:
On-site work
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