Position Summary
The Licensing & Credentialing Specialist is responsible for managing and maintaining provider licensure, certifications, and credentialing requirements to ensure regulatory compliance and uninterrupted operational and billing workflows.
This role supports the same operational and revenue cycle department by coordinating provider enrollment, maintaining credentialing records, and ensuring all clinicians and professionals meet federal, state, and payer requirements.
Essential Duties & Responsibilities
Manage provider licensure, credentialing, and re-credentialing processes
Ensure all clinicians and professionals maintain active licenses, certifications, and credentials
Complete and submit payer enrollment and revalidation applications
Track and monitor license renewals, credential expirations, and compliance deadlines
Maintain accurate and up-to-date provider credentialing files and documentation
Communicate with providers, payors, and regulatory agencies regarding credentialing status
Identify and resolve credentialing discrepancies and enrollment delays
Ensure compliance with federal, state, and payer-specific credentialing requirements
Support billing and revenue cycle teams by ensuring providers are properly credentialed and enrolled
Prepare credentialing and licensing reports as requested
Assist with audits,



compliance reviews, and regulatory inspections
Maintain strict confidentiality of provider and organizational data
Required Qualifications Education
High school diploma or equivalent required
Associate's or Bachelor's degree in Healthcare Administration, Business Administration, or related field preferred
Experience
Minimum 2+ years of licensing, credentialing, or provider enrollment experience
Healthcare credentialing experience strongly preferred
Knowledge of payer enrollment and compliance regulations preferred
Certifications (Preferred)
Certified Provider Credentialing Specialist (CPCS) – NAMSS
Certified Professional in Medical Services Management (CPMSM) – NAMSS
Skills & Competencies
Strong organizational and time management skills
High attention to detail and accuracy
Strong written and verbal communication skills
Ability to manage deadlines and multiple priorities
Proficiency in credentialing software, EMR systems, and Microsoft Office
Knowledge of state licensing boards and payer enrollment portals
Work Environment & Physical Requirements
Office or remote work environment
Prolonged periods of sitting and computer use
Ability to maintain focus on detail-oriented tasks
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📌 Licensing & Credentialing Specialist (Monterrey)
🏢 Cerebrocare
📍 Monterrey