Medical Licensing and Credentialing Specialist (Remote)

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Requirements:

• Valid U.S. work authorization.
• High school diploma or equivalent required; Associate's or Bachelor's degree preferred.
• Certified Provider Credentialing Specialist (CPCS) is preferred.
• Minimum of 3 years’ experience in medical credentialing, licensing, and provider enrollment.
• Knowledge and experience with medical coding (CPT, ICD-10, HCPCS) and patient invoicing is preferred.
• Familiarity with payer systems, including Medicare, Medicaid, and private insurance plans.

Responsibilities:

• Manage and coordinate the licensing process for all MDs and APPs, ensuring compliance.
• Handle credentialing process with insurance carriers and medical groups.
• Maintain knowledge of healthcare regulations and payer policies.
• Prepare and submit documentation for credentialing and re-credentialing.
• Monitor expiration dates for medical licenses and credentials.
• Assist with generating accurate patient invoices.
• Collaborate with insurance companies for billing issues.
• Apply appropriate medical codes for services rendered.