Credentialing Specialist

Who We Are   At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well-being of an underserved community and their families. Our multi-disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare-eligible Hispanic seniors.    Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both, our patients and our team. We believe that a rich tapestry of experiences,  shared interests, and perspectives enhances the care we provide, making us a stronger, service-centered,  and more compassionate healthcare family and Employer of Choice!  Will you join us Suvidanos , to help achieve our Higher Purpose?   What Makes Us Unique    We are an empowered primary care team, clinical operations, and support team creating health equity through an exceptional clinical and consumer experience that improves the quality of life for the people, families, and neighborhoods we serve. We tailor our primary care program to the culture, language, social, and overall well-being of the seniors we serve.    How We Work Our Culture & Core Beliefs Earn Trust Building Relationships Creating Joy Doing Right Improving Every Day Moving Forward Our Promise Purpose Driven Career Competitive Pay Best-In-Class Medical/Dental Coverage  Free Mental Health & Life Coaching for Team Members and their Dependents Holiday Time Off with Pay Paid Community Service Day Paid Parental/Family Leave Paid Bereavement Leave Generous Paid Time Off (PTO) 401k Retirement Plan with Company Match And much more.... What You’ll Do    Position Summary The Credentialing Coordinator plays a vital role in ensuring Suvida Healthcare’s providers are credentialed and recredentialed accurately and in a timely manner. This position works closely with the Compliance, Billing and Coding, Operations, and external partners, to maintain current and accurate records for all clinical staff across all Suvida’s markets. Design marketing and educational materials including brochures, flyers, infographics, web and email campaigns, social media visuals and presentations, tailored to specific healthcare products or services. Responsibilities Coordinate initial credentialing, recredentialing, and privileging processes for all providers, including physicians, nurse practitioners, and other licensed professionals. Partner with external credentialing vendors to manage credentialing workflows and documentation tracking. Collect, review, and verify required documentation such as state licenses, DEA certifications, board certifications, professional medical malpractice liability coverage, and education/training. Maintain accurate and up-to-date provider profiles in credentialing databases and ensure compliance with internal policies and external regulations. Track expiration dates of licenses, certifications, and insurance, sending timely reminders to providers for renewals. Assist with payer enrollment, including gathering required documentation and ensuring timely submission to insurance companies. Collaborate cross-functionally with operations, compliance, clinical leadership, and health plan partners to ensure credentialing status does not delay onboarding or billing. Participate in audits and reporting related to credentialing, privileging, and payer enrollment as needed. Continuously improve credentialing processes to support scaling and compliance in a fast-growing healthcare organization. Provide excellent service to internal stakeholders and represent Suvida’s core values in all interactions.     What You’ll Bring   Knowledge, Skills, and Abilities Minimum of 2 years of experience in credentialing, privileging, or provider enrollment, preferably in a healthcare setting Knowledge of NCQA, CMS, and enrollment in Medicare / Medicaid Experience working with credentialing software and databases (e.g., PECOS, Medicred, CAQH, Availity) Strong attention to detail and ability to manage multiple tasks and deadlines Excellent communication and organizational skills Ability to maintain confidentiality and handle sensitive information professionally Experience supporting a multi-site, multi-state medical group Familiarity with value-based care models, accountable care organizations (ACOs) or management services organization (MSO Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) a plus Bilingual in English and Spanish Preferred    Education, Experience, Licensure, or Certification Requirements High school diploma or equivalent; associate or bachelor’s degree preferred Suvida Healthcare provides equal employment opportunities to all Team Members and applicants for employment and prohibits discrimination and harassment of any type with regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.