Credentialing Specialist

Posted 2025-10-26
Remote, USA Full Time Immediate Start
OverviewThis position operates on an Eastern time zone schedule. Position SummaryResponsible for performing all tasks related to the credentialing, filing, updates and follow up for CPa Medical Billing. Job Type: Full-timePay: $19.00 - $25.00 per hourBenefits:401(k)401(k) matchingDental insuranceEmployee assistance programHealth insuranceLife insurancePaid time offReferral programVision insuranceSchedule: Monday to FridayWork Location: RemoteResponsibilitiesESSENTIAL FUNCTIONS & RESPONSBILITIESComplete credentialing and/or re-credentialing applications for physicians and ancillary providers with third-party payers and governmental programs (Medicare and Medicaid) as requested by the client in an accurate and timely mannerComplete, update and maintain Council for Affordable Quality Healthcare (CAQH) profiles for providersEnsure credentialing data needed for enrollment, contracting, and other related purposes is on file. Maintain provider credentialing files electronicallyMaintain credentialing software with current informationReach out to insurance carriers regarding any outstanding items/applicationsResolve issues related to provider participationRespond to various inquiries from participating physicians, staff, hospitals, and managed care companies timely and with professionalismMaintain a strict level of confidentiality for all matters pertaining to provider credentialsCommunicate client/enrollment issues to management at an early stageMust be able to work on various projects as assigned by Credentialing ManagerOther duties as assignedQualificationsEDUCATION: High school diploma or GED equivalentEXPERIENCE: Three to Five years of relevant healthcare experience is required including specialized skills in Credentialing. Experience with Windows applications, proficient use of computer, Microsoft Word, Outlook and Microsoft Excel. Strong communication, verbal and written and interpersonal skills. Ability to analyze and solve problems with limited assistance. LANGUAGE SKILLS: Knowledge and use of the English language, Bi-lingual a PlusMATHEMATICAL SKILLS: Basic math skillsREASONING ABILITY: Critical thinking, analytical and problem-solving skillsA successful candidate will have the following:Outstanding customer service, interpersonal and written skills. The ability to work independently, as well as, in a team settingExceptional organization and time management skills to manage priorities and deadlinesStrong attention to detail and qualityProficiency with Microsoft Office Suite (Word,Outlook); Excel preferredOriginally posted on Himalayas Apply To this Job
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