Credentialing Specialist

Job Summary

Coordinating and executing the credentialing and re-credentialing process for healthcare providers, the fully remote Credentialing Specialist will ensure compliance with regulatory, accreditation, and payer requirements while maintaining accurate credentialing records.

Key responsibilities

• Manage the full credentialing and re-credentialing process for assigned providers
• Conduct primary source verification of licenses, board certifications, education, training, and work history
• Submit and track credentialing applications to health plans, payers, and provider networks

Required qualifications

• High School diploma or equivalent
• 2+ years of relevant credentialing experience
• Working experience in CAQH, PECOS, Availity, and Verity
• Willingness to learn and build a process around onboarding new clients for payer claim enrollment
• Able to handle sensitive and confidential information with discretion