Credentialing Specialist

• erform end-to-end credentialing and re-credentialing for healthcare providers with US insurance payers
• Handle payer enrollments (Medicare, Medicaid, and commercial plans) to ensure billing readiness
• Maintain and regularly update CAQH profiles, ensuring accuracy for claim processing
• Verify provider eligibility before onboarding to avoid claim rejections/denials
• Coordinate closely with medical billing teams to resolve credentialing-related claim issues
• Monitor and follow up on pending applications to prevent revenue delays
• Ensure all provider data (NPI, taxonomy, licenses, malpractice insurance) is accurate and up to date
• Work on ERA/EFT enrollments to streamline payment processes
• Support denial management by identifying credentialing gaps impacting reimbursements
• Maintain compliance with payer-specific guidelines and regulatory requirements
• Prepare credentialing status reports, turnaround time tracking, and aging reports

Job Type: Full-time

Work Location: In person