Senior Credentialing Specialist

Business Title: Sr. Credentialing Specialist - temp

System Title: Specialist II, Credentialing

FLSA: Non-Exempt, Hourly 30hours a week

Pay Grade: 4

Location: Remote

Reports To: Director, Data Operations

Who We Are

We are streamlining the durable medical equipment (DME) process by managing intake, documentation, routing, claims, billing, and patient support. Our model reshapes how DME is delivered and experienced.

Since 2016, with decades of industry and leadership experience, we have delivered technology-based solutions that help partners modernize operations, improve coordination, and reduce administrative burdens. By taking on operational and financial complexity, we are redefining how DME works for providers, prescribers, and patients.

What We Need

The Sr. Credentialing Specialist plays a critical leadership role within the Credentialing function, supporting operational excellence, regulatory compliance, and team development. This role is responsible for overseeing day-to-day credentialing activities while also serving as a subject-matter expert and mentor for the Credentialing team.

In this role, you will ensure that all vendors, suppliers, hospices, and skilled nursing facilities maintain active, compliant status through accurate initial credentialing, ongoing monitoring, and timely re-credentialing. You will partner closely with the Credentialing Manager and cross-functional stakeholders to strengthen processes, mitigate risk, and support the continued growth and effectiveness of the credentialing program.

What You Will Do

• Support the Credentialing Manager by performing and overseeing primary source verification and sanctions screening for vendor applications.
• Ensure credentialing processes align with company policies and applicable state and federal regulatory requirements.
• Maintain compliance with licensing, accreditation, and payer requirements across all credentialed vendors.
• Oversee initial credentialing, monthly monitoring, and re-credentialing activities for new and active vendors.
• Maintain accurate and complete credentialing files, including state licenses, malpractice insurance, and other required documentation.
• Track licensure, certification, and professional liability expiration dates and proactively manage renewals.
• Perform regular queries of federal and state sanction and exclusion databases and document findings accordingly.
• Enter and maintain accurate data within credentialing systems and databases.
• Coordinate with Risk Management, Practice Plan Administrators, and Medical Staff Offices to verify malpractice coverage, hospital affiliations, and credentialing eligibility.
• Provide guidance, training, and mentorship to Credentialing team members, supporting consistent quality and adherence to standards.
• Identify opportunities to improve credentialing workflows, documentation practices, and compliance controls.

What You Have

We’ve intentionally built a culture rooted in kindness, collaboration, and creativity — qualities we consider essential for every team member.

Additional requirements include:

• 3–5 years of experience in medical staff or payer credentialing.
• Associate’s or Bachelor’s degree (or equivalent relevant experience).
• Strong working knowledge of credentialing regulations, standards, and best practices.
• Proficiency in Microsoft Office applications and the ability to quickly learn role-specific systems and tools.
• Excellent organizational skills with the ability to manage multiple credentialing workflows simultaneously.
• Strong verbal and written communication skills across internal and external stakeholders.
• Analytical and problem-solving skills with a high level of accuracy and attention to detail.

What Sets You Apart

Adaptability:

You respond quickly to change and are comfortable adjusting processes and priorities as needed.

Communication:

You effectively exchange information with stakeholders at all levels and translate requirements clearly.

Customer Focus:

You partner with internal and external customers to understand needs and deliver reliable, compliant outcomes.

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