Credentialing Specialist

Summary

Join Belle, a rapidly growing healthcare company, as a Credentialing Specialist. You will play a crucial role in ensuring access to Belle's services by securing in-network Medicare Advantage contracts and credentialing providers. This remote, full-time or part-time position involves managing the credentialing process for Medicare, Medicaid, and Medicare Advantage payers, maintaining strong relationships with health plans, and ensuring compliance with regulatory standards. You will also manage pre-employment credentialing for all workforce members and maintain accurate records. The ideal candidate possesses 3-5+ years of experience in healthcare credentialing and payer enrollment, strong knowledge of regulatory requirements, and excellent organizational and communication skills. Belle offers competitive compensation, comprehensive benefits, and significant career growth opportunities.

Requirements

• 3–5+ years of experience in healthcare credentialing and payer enrollment, preferably with Medicare plans
• Strong knowledge of regulatory and accreditation requirements (CMS, NCQA, URAC)
• Familiarity with CAQH, PECOS, NPPES, and other credentialing platforms
• Excellent organizational skills and attention to detail
• Strong interpersonal and communication skills with the ability to manage external and internal stakeholders
• Experience using credentialing software or provider management tools

Responsibilities

• Leading and managing the group and individual provider credentialing and contracting process for Medicare, Medicaid, and Medicare Advantage payers
• Monitoring and managing payer enrollment timelines to support market launches and state expansions
• Maintaining strong relationships with health plans and serve as the point of contact for credentialing and enrollment-related communications
• Maintaining credentialing files and documentation in accordance with payer, CMS, NCQA, and URAC standards
• Ensuring timely (re)credentialing of physicians, nurse practitioners, and clinical staff
• Managing pre-employment credentialing for the entire workforce, including clinical and non-clinical roles
• Ongoing monitoring and auditing of background checks, drug screenings, licensure verifications, and other onboarding requirements
• Coordinating closely with the HR and Compliance teams to maintain up-to-date workforce records
• Maintaining a credentialing database and producing regular reports on application status, turnaround times, and compliance metrics

Preferred Qualifications

Experience in a multi-state or fast-growth healthcare company

Benefits

• Competitive compensation based on experience
• Health, Dental, and Vision Insurance Benefits
• 401k
• PTO, Sick, and Paid Holidays
• Opportunity for significant career growth and expansion of responsibilities
• Ability to reshape an industry and protect lives