[Hiring] Credentialing Specialist @usebridge.com

Role Description

The Credentialing Specialist plays a critical role in ensuring the accuracy, efficiency, and compliance of provider credentialing processes within a growing digital health environment. This position is responsible for managing provider credentialing, enrollment, and re-credentialing with health plans, regulatory bodies, and partner organizations. The ideal candidate has a strong understanding of credentialing best practices, compliance requirements, and digital tools to streamline workflows.

• Process and manage provider credentialing applications, ensuring compliance with federal, state, and payer requirements.
• Maintain accurate and up-to-date provider records within credentialing databases and digital health platforms.
• Verify provider credentials, including licensure, certifications, education, training, and work history.
• Coordinate with internal teams and external stakeholders to ensure timely credentialing and payer enrollment.
• Monitor and track credentialing deadlines, expirations, and re-credentialing requirements.
• Identify and implement process improvements using digital tools and automation.
• Stay up-to-date with industry regulations, payer policies, and accreditation standards (NCQA, CMS, CAQH, etc.).
• Assist with audits, reporting, and data analysis related to provider credentialing and compliance.
• Support provider onboarding processes including communicating with providers directly in a professional manner to ensure a seamless experience.

Qualifications

• Bachelor's degree in healthcare administration, business, or a related field preferred.
• 2+ years of experience in provider credentialing or enrollment within a healthcare or digital health setting.
• Experience using Verifiable or Medallion preferred.
• Strong understanding of NCQA, CMS, CAQH, and payer credentialing requirements.
• Proficiency in credentialing software, databases, and digital health platforms.
• Detail-oriented with strong analytical, problem-solving, and organizational skills.
• Excellent communication and interpersonal abilities to collaborate with internal teams and external partners.
• Ability to manage multiple priorities in an evolving, technology-driven environment.
• Experience with automated credentialing workflows and digital process optimization is a plus.

Company Description