Contracting & Credentialing Specialist
About the role
Your Opportunity
We're hiring a Contracting & Credentialing Specialist who will be responsible for supporting all credentialing, licensing, and payer contracting activities within the Managed Care Contracting & Credentialing Department. This role ensures MD, APRN, RPSGT, RTT profiles and facilities are appropriately credentialed and licensed (include Rx authority and autonomous practice when applicable), re-credentialed, and contracted in compliance with regulatory, payer, and organizational requirements.
This is a hands-on role reporting directly to the Sr. Manager, Contracting & Credentialing, works closely with internal stakeholders, payers, and external agencies to support timely onboarding and ongoing compliance.
At Sunrise Group, we work on a problem that affects millions: poor sleep and untreated sleep disorders. Our mission is to make diagnosis and care easier to access, and we’re proud of the experience we provide to patients. We feel responsible for making it better every day. If you’re looking for the autonomy to take ownership of your work, make an impact, and be part of a team where ideas move fast and everyone has a voice - this role is for you!
What You’ll Do
- Coordinate end-to-end provider credentialing and re-credentialing processes with commercial and government payers, including application submission
- Prepare, submit, and track credentialing applications through CAQH and payer portals
- Support payer contracting activities, including data collection, application submission, and follow-up
- Submit and follow up on licensing activities with multi-state boards and provide update and visibility to leadership
- Maintain accurate provider credentialing files in accordance with regulatory and accreditation standards (federal, state and local regulations)
- Monitor credentialing timelines and proactively address delays or deficiencies
- Serve as a liaison between providers, internal departments, and payers regarding credentialing, licensing and contracting status
- Maintain credentialing databases and ensure data integrity across systems