Payer Credentialing Specialist

Job Summary

To support a growing healthcare organization, the full-time remote Payer Credentialing Specialist will manage all aspects of staff payer credentialing, ensuring compliance with payer requirements and organizational standards while serving as the primary point of contact for credentialing and re-credentialing processes.

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
• Proficiency in Microsoft Excel, Word, and Outlook