Contracting and Credentialing Specialist

Location: Fresno, California

Company: NCARE

Job Type: Full Time

Compensation: $25.00 to $40.00 per hour, based on experience and qualifications

nCare is seeking an experienced Contracting and Credentialing Specialist to support provider enrollment, payer credentialing, and payer contracting activities for our healthcare organization in Fresno, California. This role will be responsible for managing the full credentialing lifecycle for providers, maintaining payer enrollment accuracy, supporting payer contract execution and renewals, and ensuring all provider records remain current and compliant.

We are looking for someone with at least 3 years of direct experience in healthcare credentialing and contracting who can work independently, stay organized, and manage follow up with payers, providers, and internal teams.

1. Manage initial credentialing and recredentialing for physicians and allied health providers
2. Prepare and submit provider enrollment applications with Medicare, Medicaid, and commercial payers
3. Maintain CAQH profiles and ensure provider data is complete, accurate, and regularly updated
4. Track credentialing, enrollment, and contracting applications through completion
5. Follow up with payer representatives to resolve application delays, denials, and participation issues
6. Support payer contracting activities, including new agreements, renewals, amendments, and terminations
7. Maintain organized records of provider documentation, payer contracts, effective dates, and renewal timelines
8. Coordinate collection of licenses, malpractice insurance, board certifications, DEA, NPI, and related provider documents
9. Work closely with leadership, operations, billing, and practice teams to ensure providers are properly set up before services begin
10. Monitor expiration dates and maintain a proactive recredentialing schedule
11. Prepare status reports and maintain credentialing and contracting trackers for leadership review
12. Ensure compliance with payer, state, federal, and organizational requirements

1. Minimum 3 years of experience in healthcare credentialing and payer contracting
2. Strong knowledge of provider enrollment processes for Medicare, Medicaid, and commercial payers
3. Experience working with CAQH, PECOS, NPPES, and payer portals
4. Strong understanding of provider documentation and regulatory requirements
5. Excellent organizational skills and high attention to detail
6. Ability to manage multiple deadlines and follow ups at the same time
7. Strong written and verbal communication skills
8. Proficiency with Microsoft Excel, Word, and credentialing tracking systems

1. Experience supporting a physician group, MSO, or multi specialty healthcare organization
2. Experience with specialty care or revenue cycle operations
3. Knowledge of California payer enrollment and contracting requirements
4. Associate’s or Bachelor’s degree in healthcare administration, business, or a related field
5. CPCS or similar credentialing certification is a plus

The ideal candidate is process driven, detail oriented, and comfortable owning credentialing and contracting workflows from start to finish. This person should be proactive in following up with payers, confident in maintaining accurate records, and able to communicate clearly with internal stakeholders and external payer contacts.

nCare is building strong operational infrastructure to support provider growth and payer readiness. This role is important to ensuring providers are credentialed, contracted, and set up correctly so the organization can scale efficiently and compliantly.