Top 4 Credentialing specialist Jobs in Murfreesboro Tn

Credentialing Specialist
Tennessee Pediatrics —Brentwood, TN
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- Children
- Health insurance
- Dental insurance
Quick Apply
6h
HSPD-12: Government Badging & Credentialing Specialist (Franklin, TN*)
Citizant Inc —Franklin, TN
- $38,000 - $44,000 a year
- Full-time
- Administrative experience
- High school diploma or GED
- Organizational skills
- Disability insurance
- Health insurance
Quick Apply
Credentialing Specialist
One Federal Solution —Franklin, TN
- Customer service
- Mid-level
- Administrative experience
Quick Apply
3h

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Credentialing Specialist
Kyo —Columbus, OH
Managing credentialing, recredentialing, and licensure process for clinical staff with health insurance plans, certification boards and other agencies.
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Insurance Credentialing Specialist
TOTAL CARE THERAPY LLC —Dublin, OH
Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field. Verify provider credentials and ensure compliance with payer, state…
$50,000 - $65,000 a year
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10d

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Credentialing Specialist

Tennessee Pediatrics
Brentwood, TN

Quick Apply

Job Details

Full-time
6 hours ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Provider enrollment for medical credentialing
High school diploma or GED

Full Job Description

POSITION Summary

The Credentialing Specialist supports patient access and revenue integrity by ensuring all providers are properly credentialed and enrolled with Medicaid and commercial payers. This position manages the end-to-end credentialing lifecycle for an assigned caseload of pediatric providers, including initial credentialing of new providers, ongoing maintenance of active credentials, and enrolling providers to new Tax ID Numbers (TINs) following practice acquisitions. This position reports to the Revenue Cycle Manager.

POSITION RESPONSIBILITIES

This position has a variety of job responsibilities, and the Company reserves the right to add or modify the job duties at any time based on the needs of the business and patient care. Fundamental to this position is maintaining active credentials and payer enrollments so providers can deliver care without interruption. Below lists out the primary job responsibilities:

Manage the end-to-end credentialing and re-credentialing process for an assigned caseload of providers (MDs, NPs), supported by a leading credentialing software platform
Complete initial credentialing and payer enrollment for all newly hired providers to ensure timely participation across Medicaid/TennCare and commercial plans
Maintain active credentials by tracking and renewing licenses, board certifications, DEA registrations, and payer enrollments prior to expiration to prevent lapses
Enroll providers to Southern Pediatrics’ Tax ID Numbers (TINs) following acquisitions, ensuring continuity of participation and reimbursement with minimal disruption
Submit and follow up on initial and revalidation applications to Medicaid and commercial payers
Obtain and maintain hospital privileges as clinically appropriate
Maintain accurate provider profiles and track application status, expirables, and caseload progress in credentialing software (e.g., CAQH, PECOS, NPPES, Availity), escalating at-risk items
Serve as the point of contact for providers, payers, and internal teams to resolve credentialing and enrollment issues, and terminate enrollments upon provider departure
Follow Company policies, procedures, and operational guidelines, including completing required training and adopting new skills, technologies, or systems that are introduced to support patient care and business needs

POSITION QUALIFICATIONS

Below represents the intended qualifications for employees with this position:

Minimum education: high school education or GED required
Experience: minimum of two years of provider credentialing and payer enrollment experience required; experience in pediatrics or primary care, and with acquisitions and Tax ID (TIN) enrollments, is preferred

POSITION SKILLS

To be successful in this position, employees must demonstrate a diversity of skills related to credentialing, accuracy, and communication. Below are some of those skills:

Strong understanding of the end-to-end credentialing and enrollment process for pediatric providers across commercial plans and Medicaid (including TennCare)
Familiarity with credentialing systems and payer portals, including CAQH, PECOS, NPPES, and Availity
Proficiency using credentialing software to track licenses, expirables, application status, and caseload
Ability to manage a high-volume caseload and meet productivity and turnaround targets
Strong time management, attention to detail, and effective written and verbal communication

OUR MISSION AND VALUES

All positions at Southern Pediatrics are expected to represent and embody our mission and values:

Our mission: Southern Pediatrics exists to accelerate access to comprehensive care so all children have the opportunity to thrive.

Our values: we have three values, our ABCs – Action-oriented, always accountable; Boundless moves, bold hearts; Compassion in every connection.

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance

Experience:

provider credentialing and payer enrollment: 2 years (Required)

Ability to Commute:

Brentwood, TN 37027 (Required)

Work Location: Hybrid remote in Brentwood, TN 37027

Quick Apply

Refine Your Search

credentialing specialist jobs in murfreesboro tn

Credentialing Specialist

HSPD-12: Government Badging & Credentialing Specialist (Franklin, TN*)

Credentialing Specialist

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