Credentialing Specialist

Job Summary

To support timely and compliant provider onboarding, the full-time Credentialing Specialist will manage the end-to-end process of credentialing, recredentialing, and payer enrollment for healthcare providers while working remotely.

Key responsibilities

• Coordinate initial credentialing, recredentialing, and payer enrollment processes for various healthcare providers
• Ensure compliance with documentation and regulatory standards while preparing for internal and external audits
• Serve as a liaison between various departments to align credentialing timelines with provider start dates and clinical scheduling

Required qualifications

• Minimum of two years of experience in provider credentialing or payer enrollment in a healthcare setting
• High School Diploma or General Education Development (GED) required
• Proficiency with CAQH, PECOS, NPPES, and payer enrollment portals
• Familiarity with CMS regulations and Hawaii-specific Medicaid requirements
• Experience with credentialing software preferred