COMPREHENSIVE EYECARE PARTNERS LLC GROUP
Location
Henderson, Nevada
The Credentialing Specialist provides administrative support to the Regional Credentialing Team by maintaining provider data accuracy and managing payer-related updates. Key duties include coordinating insurance directory rosters, managing CAQH attestations, and collaborating with practice leadership to ensure compliance.
Candidates must have at least three years of credentialing experience and proficiency with CAQH, Availity, and Microsoft Office. A high school diploma is required, while a bachelor's degree and CPCS certification are preferred.
The Credentialing Specialist will provide operational and administrative support to the Regional Credentialing Team across multiple regions and practices. This role is responsible for maintaining provider data accuracy, assisting with payer-related updates, supporting onboarding workflows, and ensuring credentialing maintenance tasks are completed in a timely and organized manner. Roles and Responsibilities Coordinate and submit quarterly insurance directory roster updates for providers and practices across all applicable insurance companies and regions. Maintain accurate provider demographic information to support payer compliance and patient access. Update and maintain provider information within payer portals as required. Manage provider attestations for credentialing databases including CAQH and ProviderSource. Verify provider information, upload required documentation, and complete attestations within required timeframes. Assist with maintenance and updates for Insurance Grid projects across all regions. Collaborate with practice leadership and operational staff to maintain accurate insurance participation information. Perform data entry and ongoing maintenance within credentialing software systems. Ensure provider records, credentialing statuses, and timelines remain accurate and up to date. Assist with maintenance and development of project boards via Monday.com for operational tracking and visibility. Assist with time-sensitive credentialing and administrative requests as needed. Communicate professionally with payer representatives via phone and email regarding credentialing matters. Other duties as assigned Experience Requirements Minimum of three (3) years of credentialing experience required. Clear understanding of payer enrollment and credentialing process is required. Familiarity with CAQH, Availity, payer portals, and credential databases is required. Proficiency in Microsoft suite products: Excel, Word, PowerPoint, and Outlook is required. Proficient in Adobe Acrobat and DocuSignis preferred Experience with Monday.com or similar workflow/project management platforms preferred Strong organizational and multitasking skills with high attention to detail Comfortable communicating with insurance payers and provider offices via phone and email Excellent written and verbal communication skills Ability to work independently and prioritize tasks in a fast-paced environment. Ability to maintain professionalism and confidentiality while handling sensitive provider information. Ability to professionally conduct payer follow-up and escalation calls regarding credentialing and enrollment statuses. Education Requirements High School Diploma or equivalent required Bachelor’s degree preferred Certified Provider Credentialing Specialist (CPCS) preferred. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is primarily required to sit for extended periods, use hands for typing and operating computer equipment, and talk or hear while communicating with callers. The employee may occasionally be required to stand or walk within the call center environment. The employee must have the ability to maintain focus and concentrate on tasks amidst potential distractions. Specific vision abilities required by this job include close vision for reading and distance vision for viewing computer screens. The physical demands of this position typically involve minimal lifting or carrying of objects, not exceeding 10 pounds. Qualifications
Licensed Practical Nurse LPN
Home Health Registered Nurse- Pahrump PRN
Patient Care Technician - PCT
Integrated Care Coach
Registered Dietitian
Remote Tele-Radiologist | High Earnings + NJ License Support