Credentialing Specialist

Albany, NY

Full time

JR103500

Where people get better at life!

Join us in our mission to make a difference and shape a more inclusive future.

The Center for Disability Services offers hope, innovation and achievement to the people we support. For 80 years, we have been one of upstate New York’s largest providers of programs and services for individuals who have disabilities. Many of the innovative programs and vital services that we offer are not available elsewhere.

We are searching for a Credentialing Specialist to join our Center Health Care Team!

This role supports healthcare providers by managing credentialing and re-credentialing activities, maintaining accurate records, and coordinating with insurance payers, licensing boards, and internal stakeholders.

Responsibilities:

• Coordinate the initial credentialing, re-credentialing, and privileging processes for healthcare providers.

• Verify provider qualifications, including licenses, certifications, education, training, work history, malpractice coverage, and professional references.

• Prepare and submit credentialing applications to insurance payers and regulatory agencies.

• Monitor provider licenses, certifications, DEA registrations, and other required credentials for expiration and renewal.

• Maintain accurate provider records in credentialing databases and document management systems.

• Ensure compliance with NCQA, Joint Commission, CMS, state, and organizational credentialing requirements.

• Conduct primary source verification and maintain supporting documentation.

• Track application statuses and follow up with providers, payers, and credentialing entities as needed.

• Assist with audits, accreditation reviews, and regulatory reporting requirements.

• Respond to provider and stakeholder inquiries regarding credential status and requirements.

• Generate reports and analyze credentialing data to support operational and compliance objectives.

• Collaborate with provider enrollment, contracting, compliance, and operations teams.

Requirements:

• High School diploma or equivalent

• At least 2 years of experience in credentialing, provider enrollment, healthcare administration, or related experience

Experience Preferred:

• Certified Provider Credentialing Specialist (CPCS) certification.

• Experience with CAQH, PECOS, NPPES, and provider enrollment systems.

• Familiarity with NCQA, Joint Commission, CMS, and state licensing requirements.

• Experience in a medical group, health plan, or healthcare organization.

At The Center for Disability Services, we don't just accept difference—we celebrate it, support it, and thrive on it for the benefit of our employees and the people we support. We are proud to be an Equal Opportunity Employer and do not discriminate against any protected class of job applicant or employee in our employment practices.

Compensation Range:

$26.00 - $28.00

Benefits:

• Medical Insurance

• Dental Insurance

• Vision Insurance

• 401(k) Retirement Savings Plan

• EAP (Employee Assistance Program)

• Generous Paid Time Off (PTO)

• Tuition Reimbursement

• Early Access to Pay with RAIN

• Public Service Loan Forgiveness (PSLF)

For over 80 years, the Center for Disability Services has served as a trusted community leader, providing innovative programs and services for individuals with intellectual and developmental disabilities here in the Capital Region and North Country. We are committed to empowering individuals to lead full, independent lives, and have served over 12,000 people to date.At the Center, we firmly believe that no job is too small when it comes to making a difference in the lives of people with disabilities. As a team, every employee plays an integral part in our mission to empower individuals and promote independence. Whether you're directly involved in patient care, coordinating programs, managing operations, or providing essential support, your contribution is vital to creating a brighter and more accessible world for those we serve.Join us in our mission to make a difference and shape a more inclusive future.