Job Description

Position Overview:

A growing healthcare organization is seeking a detail-driven, organized, and proactive Credentialing Specialist with specialized experience in medical laboratory credentialing . This full-time role offers flexibility for on-site or remote work and provides an exciting opportunity to thrive in a dynamic healthcare environment focused on excellence and compliance.

Key Responsibilities:

• Collaborate with insurance carriers and internal leadership to develop, negotiate, and implement agreements .
• Lead strategic initiatives for contract negotiation and management , ensuring optimal terms and alignment with business goals.
• Oversee provider enrollment with Medicare, Medicaid, and commercial payers , handling all aspects from initial application to final approval.
• Maintain up-to-date registrations, licensing, and provider/lab information across multiple platforms.
• Manage re-credentialing processes to ensure uninterrupted payer participation.
• Utilize payer portals and systems (such as CollaborateMD ) for application submissions, tracking, and updates.
• Support contract review by analyzing and negotiating insurance fee schedules .
• Build and sustain strong working relationships with third-party payers, partner organizations, and internal stakeholders.
• Actively participate in team meetings and consistently represent the organization with professionalism and a service-oriented mindset.

Required Qualifications:

• Minimum 2 years of hands-on experience specifically in medical laboratory credentialing (this is a strict requirement).
• In-depth knowledge of payer enrollment workflows , credentialing systems , and healthcare compliance standards .
• Proficiency with Microsoft Office Suite and familiarity with billing or practice management software (experience with CollaborateMD preferred).
• Ability to generate reports , analyze data , and effectively communicate credentialing metrics .
• Exceptional organizational abilities, attention to detail, and a strong commitment to meeting deadlines in a fast-paced environment.
• Excellent interpersonal, written, and verbal communication skills.
• Capacity to manage multiple concurrent tasks while adapting to shifting priorities.
• Physical ability to occasionally lift up to 25 pounds (e.g., handling files or documentation).

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