Credentialing Specialist

Job Summary

Supporting provider credentialing and payer enrollment functions, the full-time Credentialing Specialist will manage end-to-end credentialing processes for multiple healthcare clients, ensuring compliance and accuracy while working remotely.

Key responsibilities

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

Required qualifications

• Associate's or Bachelor's degree preferred in Healthcare Administration or related field
• Minimum 2 years of credentialing or provider enrollment experience, preferably in an RCM vendor 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