Credentialing Specialist

Summary

Join our growing medical billing team as a detail-oriented Credentialing Specialist! Manage all aspects of provider credentialing and re-credentialing with insurance payers, hospitals, and medical groups. This remote role demands strong organizational skills and a deep understanding of healthcare credentialing. You will coordinate and complete applications, maintain accurate provider data, monitor timelines, and communicate with various stakeholders. Efficiently resolve credentialing issues and provide regular status updates to leadership. A minimum of two years of experience in healthcare credentialing and payer enrollment is required.

Requirements

• 2+ years of experience in healthcare credentialing and payer enrollment (medical billing experience a plus)
• Strong knowledge of commercial insurance, Medicare, and Medi-Cal enrollment processes
• Familiarity with CAQH, PECOS, NPPES, and provider portals
• Excellent attention to detail and organizational skills
• Ability to manage multiple credentialing files and deadlines simultaneously
• Strong written and verbal communication skills
• Proficient in Microsoft Office Suite (Excel, Word, Outlook); experience with credentialing software preferred
• Self-motivated and capable of working remotely with minimal supervision
• High school diploma or GED required; associate or bachelor’s degree preferred

Responsibilities

• Coordinate and complete initial and re-credentialing applications for healthcare providers
• Maintain current and accurate provider data in all systems and credentialing databases
• Monitor credentialing timelines to avoid lapses in privileges or payer enrollment
• Communicate with insurance companies, medical groups, and hospital credentialing departments to follow up on application statuses
• Assist with provider enrollments, group contracts, and insurance updates
• Provide regular updates and reports to leadership on credentialing status
• Resolve credentialing issues efficiently and professionally

Preferred Qualifications

• Experience credentialing providers in California, Utah and Texas
• Knowledge of podiatry, primary care, or multi-specialty practices