Credentialing Specialist

Location: Remote

Department: Credentialing

Location Type: REMOTE

Employment Type: CONTRACT

• Own end-to-end provider credentialing from intake through committee-ready files, completing PSV and ensuring compliance with NCQA standards and internal policy.
• Maintain data integrity across systems by proactively reconciling discrepancies and tracking licenses, certifications, training, and expirables to keep records audit-ready.
• Continuously improve throughput and quality by leveraging digital tools and automation and staying current on NCQA, CMS, CAQH, and payer policy changes.
• Collaborate across payer enrollment and partner operations teams to streamline handoffs, solve problems quickly, and build repeatable processes that improve enrollment speed and quality.
• Support partner and provider communication by helping unblock complex escalations, drafting crisp updates, and coordinating internal and external stakeholders as needed.
• Conduct QA on credentialing files against internal rubrics and NCQA standards before committee submission, identifying and resolving discrepancies, time gaps, and red flags.

• 2–5+ years of credentialing experience in a high-volume, fast-paced environment (digital health, MSO, or healthcare operations).
• Exceptional written and verbal communication skills and comfortable (and confident) coordinating across internal and external stakeholders, translating complex credentialing issues into clear updates, next steps, and expectations.
• Detail-oriented with strong organizational skills and able to manage a large queue of credentialing files across multiple and partners without dropping balls.
• Proficiency in startup tech stack (Google Workspace, Notion, Slack, etc…). Experience with Salesforce or similar CRM/credentialing platforms (Verifiable, Medallion, or similar) preferred.
• Experience with digital process optimization is a plus, along with a strong understanding of NCQA, CAQH, and/or experience using credentialing software such as Verifiable, Medallion, Andros, CertifyOS, or similar.

• Be a foundational member of a company revolutionizing how clinics interact with insurance; partnering directly with clinic leaders.
• Direct impact on patient access, clinic sustainability, and affordability of care.
• Strong support from leadership; a culture that values experimentation, clarity, and doing the hard stuff right.