Credentialing Specialist - Hawaii

Job Summary

Managing the full scope of provider credentialing and payer enrollment, the full-time Credentialing Specialist - Hawaii will ensure compliance with regulations and policies while collaborating with various departments to support timely provider onboarding and maintain accurate documentation remotely.

Key responsibilities:

• Coordinate the end-to-end process of initial credentialing, recredentialing, and payer enrollment for healthcare providers
• Ensure accurate documentation and maintain audit-ready digital files in compliance with internal and external standards
• Serve as the credentialing liaison to various departments, tracking progress and communicating issues to stakeholders

Required qualifications:

• Minimum of two (2) 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 is preferred