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Credentialing Specialist

Phoenix, AZ

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Busy and reputable specialty and pharmaceutical company in Phoenix (85054) in search of an experienced Credentialing Specialist.

The Credentialing Specialist will be responsible for all aspects of credentialing and re-credentialing of healthcare providers in compliance with state and federal standards.

The Credentialing Specialist responsibilities include:

  • Working directly with Contracting/Credentialing Manager on daily assignments
  • Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications
  • Maintain internal provider grid to ensure all information is accurate and logins are available
  • Update each provider’s CAQH database file timely according to the schedule published by CMS
  • Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance
  • Complete revalidation requests issued by government payers
  • Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid
  • Complete re-credentialing applications for commercial payers
  • Work closely with intake staff and billing staff to identify and resolve any denials or authorization issues related to provider credentialing
  • Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases
  • Identifying discrepancies in information and conducting follow-ups
  • Interacts with representatives from health plans to answer inquiries and clarify requirements
  • Other duties as assigned

Competitive compensation dependent on experience!



Job Requirements


  • High School Diploma
  • 2 years of credentialing experience preferred
  • 2 years experience in a medical practice/business office role required
  • Knowledge and understating of the credentialing process
  • Excellent computer skills, including Excel, Word and internet use
  • Detail oriented with great organizational skills
  • Be able to plan and prioritizes to meet deadlines
  • Must posses problem-solving skills, be able to research, and multi-task
  • Must posses good communication and follow-up skills

For consideration of this role, please apply, or email your resume to

In your email, please reference  Job Posting 746681 - Credentialing Specialist


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