Credentialing and Licensing Support Specialist

The Credentialing and Licensing Support Specialist provides operational and administrative support for the company's credentialing, licensing, payer enrollment, and compliance activities. This role bridges day-to day transactional work and higher level program tasks.

Responsibilities

• Serve as a Provider Administrator for payer portals, ensuring timely onboarding and offboarding for access to appropriate employees, ensure implementation of appropriate access controls
• Monitor and maintain state HME licenses and local business licenses: prepare applications, renewals, and supporting documentation; track expiration and compliance requirements
• Support Medicare and Medicaid supplier enrollment activities: asses with PECOS and regional registrations, monitor application and revalidation statuses, and escalate issues to the Manager
• Support accreditation renewal activities and ACHC standard maintenance by compiling required documentation and assisting with evidence collection
• Support internal audits, external reviews and regulatory site visit preparation by organizing records and coordinating with internal stakeholders
• Support Compliance Quarterly review
• Support Compliance Auditing and Monitoring efforts as requested
• Provide support for complaint handling/grievance assistance; escalate complex matters
• Act as a liaison between internal teams to obtain required documentation and resolve credentialing/licensing issues
• Assist with Sunshine Act data collection and other reporting tasks as assigned
• Other duties as assigned

Qualifications

Education & Experience

Required:

• 3+ years of experience in credentialing, licensing, contracts, or related administrative roles within healthcare, medical device, home health, or DME environments
• Familiarity with Medicare, Medicaid, or other third party payers, requirements, and processes

Preferred:

• Prior experience in a healthcare provider environment
• Credentialing or compliance certification (e.g., CCA, CPCS,CHC) or willingness to become certified

Knowledge & Skills

• Strong attention to detail and organizational skills
• Ability to manage multiple tasks and meet deadlines
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook)
• Comfortable navigating online portals and databases
• Excellent written and verbal communication skills
• Ability to handle confidential information with discretion
• Willingness to learn and adapt to evolving compliance requirements