Especialista en Gestion de Proveedores Medicos

About the Role We are looking for a detail-oriented and highly organized Senior Credentialing Coordinator to support our provider credentialing and recredentialing operations. This role is responsible for ensuring provider information, credentials, and documentation are accurate, complete, and up to date while maintaining compliance with applicable regulatory and accreditation requirements.

The ideal candidate has strong healthcare credentialing experience, excellent communication skills, and the ability to manage multiple priorities in a fast-paced environment.

• Manage initial credentialing and recredentialing processes for healthcare providers.
• Review provider applications and documentation for accuracy, completeness, and compliance.
• Conduct and document primary source verification of provider credentials, licenses, certifications, and registrations.
• Monitor credential and license expiration dates and proactively follow up on renewals.
• Maintain accurate and up-to-date provider records in credentialing systems and databases.
• Identify missing or inconsistent information and work directly with providers and internal teams to resolve issues.
• Support audits, regulatory reviews, accreditation activities, and compliance initiatives.
• Review credentialing records and identify potential risks, discrepancies, or compliance issues.
• Prepare credentialing documentation and reports for internal review and approval.
• Support process improvements and special projects related to credentialing operations.
• Serve as a resource for credentialing questions and assist with complex cases when needed.

• 5+ years of progressive experience in healthcare provider credentialing.
• Experience with initial credentialing, recredentialing, provider enrollment, and primary source verification.
• Knowledge of healthcare regulatory and accreditation requirements, such as NCQA, URAC, CMS, and state/federal regulations, preferred.
• Experience working with credentialing databases or systems;
  Salesforce experience is a plus.
• Strong attention to detail and excellent organizational and time-management skills.
• Ability to manage multiple priorities, deadlines, and projects independently.
• Strong analytical, problem-solving, and decision-making skills.
• Excellent written and verbal communication skills.
• Ability to work effectively with providers, clients, and internal stakeholders.
• Fully bilingual in English and Spanish strong proficiency in both written and verbal English is required.
• High school diploma or equivalent required; an Associate’s degree or relevant coursework in healthcare administration, business administration, or a related field is preferred.
• CPPS certification is a put.

Join a collaborative team where your expertise in healthcare credentialing will directly contribute to provider compliance, operational excellence, and quality service.