Credentialing Specialist

overview

provider credentialing specialist — location: remote (u.s.). Type: full time monday to friday, 9:00 a.m. To 5:00 p.m. Est.

we are seeking an experienced provider credentialing specialist to join our growing team. The ideal candidate will have a strong background in multi-state credentialing, with experience credentialing for primary; cardiology, dental, and anesthesia providers. This role requires exceptional attention to detail, accuracy, and the ability to work independently while managing multiple provider files across various payors and states.

• complete provider credentialing and recredentialing applications for multiple specialties, including cardiology, dental, and anesthesia.
• navigate and comply with state-specific medicaid and medicaid mco credentialing requirements.
• maintain accurate records of provider files, applications, and payer correspondence.
• follow up with payors, providers, and internal teams to ensure timely completion of all credentialing processes.
• interpret and apply plan-specific rules and state requirements for credentialing in each assigned region.
• support ongoing growth—currently managing credentialing for 11 states, 26 providers, and 141 locations (and expanding).
• manage and track all work using an excel spreadsheet.

• minimum 5 years of experience in provider credentialing (multi-state preferred).
• in-depth knowledge of caqh, pecos, nppes, and commercial payor platforms.
• proven experience with medicaid and medicaid managed care organizations (mcos).
• strong understanding of payer enrollment processes for both commercial and government plans.
• excellent organizational skills and follow-up practices.
• self-motivated, detail-oriented, and able to work independently.
• experience with cardiology, dental, or anesthesia credentialing is highly preferred.
• experience using excel and knowledge of creating pivot tables; able to track and follow up on all providers using this platform.
• cpcs (certified provider credentialing specialist) preferred but not required.

• full time
• competitive hourly rate based on experience
• rate: $21.00 - $23.00/hour

to apply, please submit your resume and a cover letter highlighting your relevant experience and send to:

note: your application will not be reviewed without a cover letter with your resume uploaded. If you are not in one of the 50 states in the u.s., i will not review your resume.