Credentialing and Licensing Specialist

Job Summary:

The Credentialing and Licensing Associate is responsible for managing the end-to-end credentialing lifecycle for healthcare clinicians across our medical network. This role ensures providers are accurately and efficiently credentialed, licensed, and privileged in accordance with partner clinic, hospital system, and payer requirements. The ideal candidate is highly organized, detail-oriented, and comfortable managing multiple providers and partnerships simultaneously across varying stages of the credentialing process, while communicating clearly with both internal teams and external providers.

Key Responsibilities:

Documentation & Data Management

• Collect, verify, and organize all required credentialing documentation, including licenses, malpractice certificates, board certifications, and other required credentials.
• Enter and maintain accurate provider data across credentialing platforms (including CredentialStream) and internal tracking reports.

Provider Communication & Coordination

• Communicate directly with healthcare providers to clarify outstanding questions and request missing or incomplete information.
• Prepare and send DocuSign packets, credentialing checklists, and required forms to providers.
• Coordinate the collection and submission of clinic-specific forms, privilege forms, and required attachments unique to each partner.

Application Submission & Tracking

• Submit and track provider credentialing applications on behalf of partner clinics, including hospital systems.
• Collaborate with licensing specialists to confirm all required state licenses are actively in progress prior to submitting provider applications to partner clinics for credentialing.
• Request and collect malpractice claims history reports from providers and/or their prior insurance carriers on behalf of partner clinics.
• Track and proactively communicate credentialing barriers to relevant internal and external stakeholders to avoid delays.

Required Skills and Qualifications:

• Familiarity with credentialing terminology, including COIs (Conflicts of Interest), peer references, privileges, payer enrollment, primary source verification, and CAQH/FCVS profiles.
• Understanding of the differences between MD/DO and mid-level provider (NP/PA) credentialing requirements.
• Strong attention to detail with the demonstrated ability to manage multiple providers simultaneously across various stages of the credentialing process.
• Excellent written and verbal communication skills, with the ability to professionally liaise between providers, internal teams, and partner organizations.
• Strong organizational and time-management skills; comfortable working in a deadline-driven environment.
• Proficiency with credentialing software/platforms (e.g., CredentialStream) and general comfort with data tracking tools (Excel, Google Sheets, etc.).

Preferred Qualifications:

• 2+ years of credentialing experience, ideally within telehealth or multistate credentialing environments.
• Experience working with hospital systems and health system partners on provider onboarding.
• Familiarity with DocuSign or similar e-signature/document workflow platforms.

What Success Looks like:

• Providers move efficiently through the credentialing pipeline with minimal delays.
• Credentialing barriers are identified early and communicated proactively.
• Provider and credentialing data remains accurate and up to date across all systems.
• Strong, professional relationships are maintained with providers and partner clinic contacts throughout the credentialing process.

Benefits & Perks:

• Hybrid work schedule with weekly lunches and stocked fridges
• Monthly social committees for company events
• 18 vacation days, 9 company holidays, 5 sick days, and 2 personal days
• Stock options for every full-time employee
• Paid parental leave
• 401k benefit
• Commuter Benefits
• Competitive health, dental, and vision insurance options