Payer Credentialing Specialist

Job Summary

To support the credentialing processes for providers, the full-time Payer Credentialing Specialist will manage submissions, maintain enrollments, and ensure compliance with payer requirements in a remote position available to candidates residing in PA, DE, MD, NJ, OH, FL, TX, and VA.

Key responsibilities

• Ensure timely and accurate submission of initial and re-credentialing applications for all employed and contracted providers
• Maintain active Medicare and Medicaid enrollments for all eligible providers
• Manage and update provider records across CAQH, PECOS, PROMISe, and other payer systems, ensuring accuracy and compliance

Required qualifications

• Associate Degree or two years equivalent work experience required; Bachelor's Degree preferred
• Minimum of two years of credentialing experience including work with CAQH and provider enrollment processes
• Strong knowledge of credentialing processes, including payer submissions and re-credentialing
• Experience with MD-Staff credentialing system
• Experience maintaining provider data across various payer systems, ensuring accuracy and compliance