Credentialing Specialist - Hawaii

Job Summary

Managing the full scope of provider credentialing and payer enrollment functions, the full-time Credentialing Specialist - Hawaii will ensure compliance with regulations and support timely provider onboarding while working remotely.

Key responsibilities

• Coordinate initial credentialing, recredentialing, and payer enrollment for healthcare providers across Maui Health facilities
• Ensure accurate documentation and maintain audit-ready files in compliance with internal policies and accrediting standards
• Collaborate with various departments to align credentialing processes with provider start dates and communicate progress to stakeholders

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
• Strong time management skills and attention to detail