Credentialing Specialist

Job overview

The Credentialing Specialist role is onsite in Sheboygan, WI. Compensation is not specified. Noble Community Clinics is a mission-driven organization focused on accessible, high-quality healthcare for the communities it serves. The specialist manages provider and site enrollment, payer contracting, revalidation, and related compliance activities. By keeping enrollment information accurate and current and resolving payer issues, the role supports providers’ participation with insurance payers and helps maintain patient access to care.

What you'll do

• Complete provider enrollment with insurance payers and clearinghouses
• maintain enrollment and demographic information in Credential Stream and CAQH
• track renewals and expiration dates
• coordinate revalidations and updates
• maintain payer relationships and respond to enrollment questions
• research payer requirements
• assist with denials, appeals, and escalations
• monitor compliance requirements
• protect patient confidentiality and follow HIPAA
• collaborate with internal departments and external partners.

What we're looking for

Skills & competencies

credentialing specialist

sheboygan wi

noble community clinics

provider enrollment

payer contracting

credentialing

revalidation

insurance payers

caqh

credential stream

hipaa

healthcare access

Work arrangement

• Weekend coverage required

Benefits & perks

• Benefits may include 20 days of PTO, eight paid holidays, 401(k) with up to 5% employer match, medical, dental and vision insurance, and employer-paid short- and long-term disability and life insurance.

About the employer

Noble Community Clinics is hiring for this role. Industry: Offices of Physicians (except Mental Health Specialists). Sector: 62.