Credentialing Specialist

About the job Credentialing Specialist

GTM Physician Partners is a national medical practice advisory firm, based out of Richmond, VA, dedicated to supporting physicians as they launch and manage successful medical practices. A core component of our service offering is provider and practice credentialing. We are seeking a highly organized, detail-oriented Credentialing Specialist to manage the full credentialing lifecycle for assigned clients.

In this role, you will be responsible for submitting, monitoring, and maintaining provider and practice credentials with commercial insurance carriers, Medicare, Medicaid, and other regulatory entities. The ideal candidate is reliable, proactive, and experienced with credentialing platforms such as CAQH, PECOS, NPPES, and major payer portals, with a strong ability to follow through and communicate effectively.

This is a remote, work-from-home opportunity offering significant flexibility and autonomy. If you are a self-starter who thrives in an independent work environment, we will provide the tools and support you need to succeed-along with the trust to manage your own workflow and schedule.

The position begins at approximately 20 hours per week, with the option to transition to full-time in the future, if desired. Compensation ranges from $23-$25 per hour, depending on experience.

Key Responsibilities

• Complete initial credentialing and recredentialing applications for individual providers and group practices
• Maintain accurate and current provider information in CAQH, NPPES, PECOS, and payer portals
• Submit enrollment applications to commercial payers, Medicare, Medicaid, and managed care organizations
• Track application status and proactively follow up with payers to ensure timely processing and approval
• Review provider documentation for completeness, accuracy, and compliance (licenses, certifications, malpractice insurance, etc.)
• Communicate with providers to obtain required information, documentation, and signatures
• Maintain credentialing trackers, spreadsheets, and timelines to ensure deadlines are met
• Assist with payer contracting and network participation updates as needed
• Ensure compliance with organizational policies and all applicable state and federal regulations
• Provide consistent, thorough status updates and communication to clients

Qualifications

• Prior experience in credentialing or healthcare administration, required
• Experience credentialing with multiple payers, including Aetna, Cigna, BCBS, United Healthcare, Medicare, and Medicaid, preferred
• Working knowledge of CAQH, PECOS, NPPES, payer portals, and credentialing processes
• Exceptional attention to detail and accuracy
• Strong written and verbal communication skills
• Ability to manage multiple priorities independently in a remote environment
• Proficiency with spreadsheets and credentialing tracking tools