Credenting specialist

Provider Credentialing Complete initial credentialing and recredentialing applications. Maintain provider files and ensure documentation remains current. Track expiration dates for licenses, DEA registrations, controlled substance registrations, malpractice insurance, board certifications, CPR certifications, and other required credentials. Submit applications through CAQH, PECOS, NPPES, and payer portals. Monitor application status until approval. Resolve credentialing delays and deficiencies promptly. Insurance Enrollment Enroll providers with commercial insurance carriers including: Blue Cross Blue Shield UnitedHealthcare Aetna Cigna Medicare Medicaid Optum Other contracted payers Maintain active provider participation with all contracted insurance plans. Process demographic updates including addresses, tax IDs, and practice locations. Coordinate group and individual provider enrollments. CAQH & Provider Maintenance Maintain accurate CAQH profiles. Perform quarterly CAQH attestations. Update provider information in NPPES and PECOS. Maintain provider rosters. Ensure provider data is accurate across all systems.