Cerebrocare

Position Summary

The Licensing & Credentialing Specialist is responsible for managing and maintaining provider licensure, certifications, and credentialing requirements to ensure regulatory compliance and uninterrupted operational and billing workflows. This role supports the same operational and revenue cycle department by coordinating provider enrollment, maintaining credentialing records, and ensuring all clinicians and professionals meet federal, state, and payer requirements.

Essential Duties & Responsibilities

• Manage provider licensure, credentialing, and re-credentialing processes
• Ensure all clinicians and professionals maintain active licenses, certifications, and credentials
• Complete and submit payer enrollment and revalidation applications
• Track and monitor license renewals, credential expirations, and compliance deadlines
• Maintain accurate and up-to-date provider credentialing files and documentation
• Communicate with providers, payors, and regulatory agencies regarding credentialing status
• Identify and resolve credentialing discrepancies and enrollment delays
• Ensure compliance with federal, state, and payer-specific credentialing requirements
• Support billing and revenue cycle teams by ensuring providers are properly credentialed and enrolled
• Prepare credentialing and licensing reports as requested
• Assist with audits, compliance reviews, and regulatory inspections
• Maintain strict confidentiality of provider and organizational data
   

Required Qualifications

Education

• High school diploma or equivalent required
• Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, or related field preferred

Experience

• Minimum 2+ years of licensing, credentialing, or provider enrollment experience
• Healthcare credentialing experience strongly preferred
• Knowledge of payer enrollment and compliance regulations preferred

Certifications (Preferred)

• Certified Provider Credentialing Specialist (CPCS) – NAMSS
• Certified Professional in Medical Services Management (CPMSM) – NAMSS
   

Skills & Competencies

• Strong organizational and time management skills
• High attention to detail and accuracy
• Strong written and verbal communication skills
• Ability to manage deadlines and multiple priorities
• Proficiency in credentialing software, EMR systems, and Microsoft Office
• Knowledge of state licensing boards and payer enrollment portals

Work Environment & Physical Requirements

• Office or remote work environment
• Prolonged periods of sitting and computer use