Provider Credentialing Specialist
New
J
JobgetherHealthcare Operations
Based in United StatesFull-TimeMiddle
Salary not disclosed
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Job Details
- Languages
- English
- Experience
- 2+ years
- Required Skills
- Microsoft OfficeGoogle Workspace
Requirements
- 2+ years of direct provider credentialing experience.
- Proven experience managing full credentialing workflows, including applications, payer follow-up, and documentation.
- Strong knowledge of CAQH, NPI enrollment, and payer credentialing requirements.
- Experience working with Medicare, Medicaid, and commercial insurance payers.
- Comfortable making proactive follow-up calls to insurance payers and coordinating documentation with providers.
- Exceptional attention to detail with strong deadline management.
- Ability to manage multiple credentialing projects and maintain accurate tracking systems.
- Strong written and verbal English communication skills.
- Proficiency with Microsoft Office Suite or Google Workspace.
- Reliable home office setup with stable internet connectivity.
Responsibilities
- Manage provider credentialing and re-credentialing workflows from application preparation through final approval.
- Collect, verify, and organize required documentation from providers to support enrollment processes.
- Prepare and submit credentialing applications for commercial and government payers.
- Complete re-credentialing submissions ahead of provider expiration deadlines.
- Manage NPI enrollment, PECOS enrollment, Medicare, Medicaid, and payer-specific requirements.
- Track credentialing applications, submission timelines, payer responses, approvals, and outstanding requirements.
- Maintain accurate CAQH profiles, complete attestations, and ensure provider information remains current.
- Conduct monthly sanctions checks and maintain audit-ready credentialing documentation.
- Monitor payer application statuses through proactive phone and email follow-ups.
- Act as a reliable point of contact for providers, payers, and internal stakeholders.
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