Credentialing Specialist

Job Description

REQUIREMENTS

• Previous medical credentialing experience required
• Experience with behavioral health credentialing strongly preferred
• Experience with CAQH required
• Familiarity with Medicare, Medicaid, and commercial insurance enrollment processes
• Strong attention to detail and organizational skills
• Ability to work independently in a fully remote environment
• Strong written communication skills
• Comfortable learning new systems and workflows

RESPONSIBILITIES

• Complete provider credentialing and recredentialing applications
• Manage CAQH profiles and attestations
• Handle Medicare, Medicaid, and commercial payer enrollments
• Monitor application statuses and follow up with payers
• Maintain accurate provider records and credentialing trackers
• Assist with state Medicaid portal management
• Communicate professionally with providers, payer representatives, and internal staff
• Identify and escalate credentialing issues proactively
• Ensure applications and supporting documentation are complete and accurate

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