Credentialing Specialist

Remote: 
Full Remote
Contract: 
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Offer summary

Qualifications:

2+ years of experience in healthcare credentialing and payer enrollment., Strong knowledge of commercial insurance, Medicare, and Medi-Cal enrollment processes., Excellent attention to detail and organizational skills., High school diploma or GED required; associate or bachelor’s degree preferred..

Key responsibilities:

  • Coordinate and complete initial and re-credentialing applications for healthcare providers.
  • Maintain current and accurate provider data in all systems and credentialing databases.
  • Communicate with insurance companies and medical groups to follow up on application statuses.
  • Provide regular updates and reports to leadership on credentialing status.

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CallTek XLarge https://www.calltekinc.com/
5001 - 10000 Employees
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Job description

We are seeking a detail-oriented and experienced Credentialing Specialist to join our growing medical billing team. The Credentialing Specialist will be responsible for managing all aspects of provider credentialing and re-credentialing processes with insurance payers, hospitals, and medical groups. This role requires strong organizational skills, a deep understanding of healthcare credentialing requirements, and the ability to work independently in a remote setting.

Key Responsibilities:

· Coordinate and complete initial and re-credentialing applications for healthcare providers.

· Maintain current and accurate provider data in all systems and credentialing databases.

· Monitor credentialing timelines to avoid lapses in privileges or payer enrollment.

· Communicate with insurance companies, medical groups, and hospital credentialing departments to follow up on application statuses.

· Assist with provider enrollments, group contracts, and insurance updates.

· Provide regular updates and reports to leadership on credentialing status.

· Resolve credentialing issues efficiently and professionally.

Requirements

· 2+ years of experience in healthcare credentialing and payer enrollment (medical billing experience a plus).

· Strong knowledge of commercial insurance, Medicare, and Medi-Cal enrollment processes.

· Familiarity with CAQH, PECOS, NPPES, and provider portals.

· Excellent attention to detail and organizational skills.

· Ability to manage multiple credentialing files and deadlines simultaneously.

· Strong written and verbal communication skills.

· Proficient in Microsoft Office Suite (Excel, Word, Outlook); experience with credentialing software preferred.

· Self-motivated and capable of working remotely with minimal supervision.

· High school diploma or GED required; associate or bachelor’s degree preferred.

Preferred:

· Experience credentialing providers in California, Utah and Texas.

· Knowledge of podiatry, primary care, or multi-specialty practices.

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Organizational Skills
  • Microsoft Office
  • Detail Oriented
  • Communication

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