[Hiring] Credentialing Specialist @Upstream Rehabilitation

Role Description

Join Preferred Therapy Providers, a brand partner of Upstream Rehabilitation, where your work makes a real impact! As a Credentialing Specialist, you will support the initial credentialing and recredentialing of practitioners within the Preferred Therapy Providers (PTP) network. This includes:

• Collecting and verifying practitioner information
• Conducting primary source verification
• Maintaining credentialing records
• Coordinating with contracted health plans and internal and external stakeholders

In this role, you will ensure practitioner data remains accurate and up to date, monitor licensure and certification requirements, and support credentialing activities in compliance with applicable regulations, accreditation standards, and company policies. Your attention to detail and commitment to quality will play a critical role in maintaining a high-performing provider network while advancing PTP's mission, vision, and values and contributing to the organization's continued growth and success.

Qualifications

• High school diploma or equivalent experience
• Strong attention to detail, self-motivation, and effective written and verbal communication skills
• Demonstrated ability to establish and maintain positive working relationships with providers, leadership, staff, and external partners
• Proficiency in Microsoft Office applications, including Word and Excel, Adobe Acrobat, and web-based systems
• Proven ability to organize and prioritize work, manage multiple responsibilities, and meet deadlines in a fast-paced environment

Requirements

• Maintain accurate and timely practitioner data, electronic files, and credentialing records within the credentialing database
• Access and manage practitioner information through CAQH and paper application systems
• Provide administrative support for credentialing operations
• Perform primary source verifications and maintain practitioner licensing, credentialing, certification, and insurance records
• Monitor license, certification, insurance, and continuing education requirements
• Communicate with internal stakeholders and external practitioners regarding application status and credentialing requirements
• Perform credentialing and recredentialing activities in accordance with applicable regulations and company policies
• Monitor credentialing files and outstanding requirements, proactively identifying and escalating delays or compliance concerns
• Maintain the confidentiality, integrity, and security of practitioner information and credentialing records
• Crosstrain and provide support in other functional areas as needed
• Perform other projects and duties as assigned

Benefits

• Annual paid Charity Day to give back to a cause meaningful to you
• 100% employer paid medical health insurance premium option available
• Dental and Vision insurance
• 401(k) with company match
• Generous PTO and paid holidays
• Supportive team and leadership invested in your success