Credentialing Specialist

Zarminali Pediatrics is building the nation's leading pediatric multispecialty group, focused on supporting families to shape healthy futures for their children – from birth through adulthood – by completely transforming the way pediatric care is delivered nationwide. We are tackling today's challenges of increased administrative burden on clinicians and a siloed approach to pediatric care through intentional design of care delivery, enhanced by leading technology and collaborative, expert care teams.  

Our name, inspired by our founder's daughter's name – Zarmina – means “something that is more precious to you than gold”. We couldn’t think of anything that better represents the way parents and caregivers hold the relationship with their children as the most valuable gift, and how we at Zarminali approach care for each child with equal reverence.

We strive for a healthier future for pediatric patients and a happier future for pediatric clinicians nationwide, and we are looking for people to join us in achieving this vision. If you are eager to join a growth stage company and be part of the early team that is shaping the foundation of both the company and the delivery of pediatric care, then this opportunity might be for you!

POSITION OVERVIEW

The Credentialing Specialist plays a critical role in ensuring providers across Zarminali Pediatrics’ multi-state pediatric, behavioral health, therapy, and urgent care network are accurately credentialed and enrolled with all applicable payers.

This role owns end-to-end provider enrollment, revalidation, and payer linkage processes to prevent claim rejections, reimbursement delays, and compliance gaps. The ideal candidate brings strong attention to detail, a deep understanding of payer credentialing rules, and the ability to manage a high volume of provider files across multiple states with urgency and precision.

WHAT YOU’LL DO:

• Prepare and submit provider enrollment applications for payers across multiple states
• Maintain and attest CAQH profiles, ensuring documentation and demographic information remain accurate and up to date
• Process PECOS and NPPES updates, including NPI maintenance, reassignment, and location changes
• Manage recredentialing cycles, payer revalidations, and demographic updates in compliance with payer and state timelines
• Monitor payer correspondence and proactively follow up on pending enrollments, deficiencies, and documentation requests
• Verify provider credentials including licenses, board certifications, malpractice insurance, DEA/CSR registrations, and Medicaid identifiers
• Track enrollment status using Medallion or internal credentialing systems to ensure visibility and timely escalation
• Partner with Billing and Denials teams to resolve credentialing-related denials, enrollment delays, and claim linkage issues
• Support new provider onboarding by collecting, validating, and submitting required credentialing documentation
• Maintain accurate and compliant provider files across credentialing systems and payer portals
• Contribute to monthly reporting, including enrollment status, pending items, turnaround times, and payer approvals
• Ensure compliance with CMS, NCQA, state Medicaid regulations, and internal organizational standards
• Communicate professionally with providers, payers, and cross-functional teams to facilitate timely enrollments

WHAT WE LOOK FOR:

• Strong attention to detail and ability to manage high-volume documentation with accuracy
• Experience navigating multi-state payer enrollment processes
• Proactive follow-up and problem-solving mindset
• Ability to prioritize and manage multiple providers and payer relationships simultaneously
• Clear and professional communication skills
• Comfort working in a fast-paced, deadline-driven environment
• High level of organization and ownership over timelines

WHAT YOU’LL NEED:

• 2+ years of credentialing or payer enrollment experience (multi-state experience strongly preferred)
• Working knowledge of payer enrollment processes
• Experience maintaining CAQH profiles and working within payer portals
• Familiarity with PECOS and NPPES systems
• Understanding of provider file requirements (licenses, insurance, certifications, etc.)
• Experience using credentialing platforms (Medallion or similar systems preferred)
• Familiarity with Athena EMR is a plus

WHAT WE OFFER:

• Opportunity to support a growing, multi-state pediatric health organization
• Collaborative cross-functional partnership with Billing, Operations, and Provider Recruitment teams
• Exposure to multi-market expansion and onboarding initiatives
• Structured processes with clear timelines and visibility
• A mission-driven environment focused on improving pediatric health access

Zarminali Pediatrics is a national organization, and compensation is determined using market-informed data, including industry benchmarks. Salary ranges may vary based on geographic location, local market conditions, state-specific factors, and individual qualifications, including years of experience, education, and scope of responsibility. The base salary range for this position is $47,000-60,000 + annual bonus. This range reflects the minimum and maximum base pay we reasonably expect to offer for this role at the time of posting. Actual compensation will be determined based on job-related factors such as experience, skills, and internal equity. This role may also be eligible for additional productivity or performance-based bonus incentives.  

For full-time team members, our total rewards package includes competitive base pay and performance bonus potential, along with medical, dental, and vision coverage, a 401(k) with company match, paid parental leave, 20 days of paid time off annually, 7 paid holidays plus 2 floating holidays and a supportive, inclusive and growth-focused culture.  

At Zarminali Pediatrics, we are committed to our empowering clinicians and team members to deliver better pediatric care, altogether. This commitment requires building an inclusive culture and a team that represents the diverse communities we serve. 

We believe that when people from all backgrounds, experiences, and perspectives come together, we create a stronger team and better care for our patients and their families. We realize the importance of an environment where clinicians and team members feel cared for, supported, and valued. We believe in the basics: treating everyone with kindness, respect, and fairness.

We do not tolerate discrimination or harassment of any kind. This includes, but is not limited to, race, color, sex, gender, age, religion or religious creed, national origin, ancestry, citizenship, marital status, sexual orientation, gender identity, gender expression, genetic information, physical or mental disability, military or veteran status, or any other characteristic protected by law.

We recruit and hire based on skills, talent, and potential, ensuring everyone has a fair chance to succeed. Together, we strive to build an inclusive and welcoming space where we can achieve our goal of building a happier future for the pediatric workforce.