Credentialing Specialist

Remote
Part Time to Full Time
Mid Level
Provider Credentialing Specialist
Location: Remote (U.S.)
Type: Full time Mon-Friday 9:00 a.m. to 5 p.m. EST


About the Role:
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 specific 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.


Responsibilities:
  • 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.

Qualifications:
  • 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 knowing how to create pivot tables and organize; track and follow up on all providers using this type of platform.
  • CPCS (Certified Provider Credentialing Specialist) preferred but not required.

Schedule & Compensation:
  • Full time 
  • Competitive hourly rate based on experience
  • Rate: $21.00 - 25.00/ hour

How to Apply:
To apply, please submit your resume and a cover letter highlighting your relevant experience and send to:  [email protected]

NOTE:
  YOUR APPLICATION WILL NOT BE REVIEWED WITH A RESPONSE IF, I DO NOT RECEIVE A COVER LETTER WITH YOUR RESUME UPLOADED.

**** IF YOU ARE NOT IN ONE OF THE 50 STATES IN THE US I WILL NOT REVIEW YOUR RESUME.


 
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