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 provider onboarding while working remotely.

Key responsibilities

• Coordinate the credentialing, recredentialing, and payer enrollment processes for healthcare providers across all facilities
• Ensure accurate documentation and compliance with internal policies and accreditation standards
• Serve as a liaison between credentialing and cross-functional teams, tracking progress and addressing issues as needed

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