Credentialing Specialist

Job Summary

A company is looking for a Credentialing Representative.

Key Responsibilities

• Manage end-to-end credentialing and recredentialing for providers across assigned client accounts
• Prepare, submit, and track payer enrollment and participation applications for Medicare, Medicaid, and commercial health plans
• Verify provider credentials and maintain detailed records of all credentialing activities

Qualifications

• Minimum 2 years of credentialing or provider enrollment experience, preferably with an RCM vendor or multi-client environment
• Familiarity with Medicare/Medicaid enrollment processes, PECOS, CAQH, and payer portals
• Proficient in Microsoft Office and credentialing/enrollment software
• CPCS or CPMSM certification preferred but not required
• Associate's or Bachelor's degree preferred in Healthcare Administration or related field, but not required