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 (Ejido de la Finca)
🏢 Cerebrocare
📍 Ejido de la Finca