Provider Credentialing Specialist

AO Multispecialty Clinic•North Augusta, SC

1d•Onsite

About The Position

AO Multispecialty Clinic is seeking a detail-oriented and highly organized Provider Credentialing Specialist to support our growing multi-specialty practice. This role is responsible for managing all aspects of provider credentialing, recredentialing, and payer enrollment to ensure compliance with regulatory, accreditation, and payer requirements. The ideal candidate will have strong knowledge of healthcare credentialing processes, excellent follow-through, and the ability to manage multiple deadlines in a fast-paced medical environment. AO Multispecialty Clinic is a physician-led healthcare organization serving patients across multiple specialties including Oncology/Hematology, Rheumatology, Urology, Plastic Surgery, and Radiation Therapy. Our team is committed to delivering high-quality care while supporting providers with efficient systems and operational excellence.

Requirements

Minimum 2–3 years of provider credentialing and payer enrollment experience required
Experience credentialing providers in a multi-specialty or multi-location practice preferred
Working knowledge of Medicare, Medicaid, and commercial payer enrollment processes
Experience with CAQH, PECOS, and state Medicaid portals required
Strong attention to detail and ability to manage multiple deadlines
Excellent communication and organizational skills
Proficiency with Microsoft Office and credentialing or practice management systems

Nice To Haves

CPCS (Certified Provider Credentialing Specialist) or CPMSM certification
Experience supporting Revenue Cycle or medical billing operations
Understanding of how provider enrollment impacts claims submission and reimbursement

Responsibilities

Manage initial credentialing and recredentialing for physicians and advanced practice providers across multiple specialties and locations
Complete and submit payer enrollment applications for commercial insurance, Medicare, Medicaid, and managed care plans
Maintain and update provider records within credentialing databases and CAQH profiles
Monitor credential expiration dates including: State licenses DEA registrations Board certifications Malpractice insurance Hospital privileges
Ensure timely revalidation and recredentialing with all payers
Serve as liaison between providers, payers, hospitals, and internal departments
Track application status and follow up with insurance carriers to ensure timely approvals
Maintain compliance with CMS, NCQA, Joint Commission, and payer standards
Assist Revenue Cycle and Practice Operations teams with enrollment-related billing issues
Maintain organized electronic credentialing files and audit-ready documentation