Credentialing Specialist

Job Summary

Managing the full scope of provider credentialing and payer enrollment, the full-time Credentialing Specialist will ensure compliance with policies and regulations while supporting timely provider onboarding in a remote environment.

Key responsibilities:

• Coordinate initial credentialing, recredentialing, and payer enrollment for healthcare providers across all facilities
• Ensure accurate documentation and maintain audit-ready files in compliance with internal policies and accrediting standards
• Serve as a liaison between credentialing and various departments, tracking progress and resolving issues to ensure timely onboarding

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