credentialing specialist

Round Table Medical Consultants LLC

<div>The Credentialing/Contracting Specialist will be responsible for all tasks associated with physician privileging and medical staff membership credentialing. The Specialist will communicate with outside agencies, including physician offices, hospitals, insurance carriers, and other healthcare agencies as required.
<ul><li>Minimum Education: High School Diploma/G.E.D.
</li><li>Minimum 3+ years of experience with physician and facility credentialing is required.
</li><li>Experience with insurance carrier credentialing preferred</li><li>
Maintain strong skills in diplomacy, professionalism, and trustworthiness.
</li><li>Strong communication skills in both oral and written.
</li><li>Positive attitude, Team Player, and ability to work independently.
</li><li>Knowledge of EPower and Centricity is a benefit.</li><li>
Strong working knowledge of computers and Windows PC applications, such as Excel and Word, including the ability to learn new computer systems and applications.</li><li>
Ability to manage multiple priorities and projects.
</li><li>Detail-oriented with a desire to produce work with 100% accuracy.
</li><li>Excellent analytical and problem-solving skills.</li></ul>
JOB RESPONSIBILITIES/ DUTIES<ul><li>
Responsible for internal credentialing of all providers in the practices and external consultants coming to the practices.
</li><li>Responsible for credentialing facilities with insurance carriers.
</li><li>Responsible for maintaining complete and up-to-date credentialing files for each provider and every practice to internal defined standards.
</li><li>Meets with providers to gather, review, and provide guidance on completion of credentialing packets.
</li><li>Coordinates the accurate input of physician information into CAQH, Medicare, Medicaid, and the internal tracking database.</li><li>
Responsible for the processing of accurate completion of Texas Standardized Credentialing Applications in MS Word files for each physician.
</li><li>Responsible for the input of physician documents into the database and the proper maintenance of all necessary documents mandated by the organization.
</li><li>Continuously verifies the status of CVs, provider licenses, DEA, DPS certificates, and specialty certificates; alerts leadership on any expirables not obtained and any provider who is not responding to open requests.</li><li>
Continuously tracks renewals of provider licenses, DEA, DPS, and ACLS certificates.
</li><li>Maintains record-keeping on providers&rsquo; CMEs and follows up with them to receive the CMEs they have completed.</li><li>
Ensures providers&rsquo; information is forwarded to the appropriate channels within the organization on a mandated basis.</li><li>
Completes various provider applications and tracks the status of applications once submitted to all insurance carriers.</li><li>
Maintains Contact information and provides it to leadership upon hiring of new providers and completion of the credentialing process.</li><li>
Updates the appropriate departments on the status of providers&rsquo; credentialing on Managed Care/Insurances.</li><li>
Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, member satisfaction, and attendance.</li><li>
Perform other duties as assigned by the Director of Operations as necessary.
</li></ul>WORKING CONDITIONS
<ul><li>The employee will be exposed to working conditions commensurate with a traditional office environment.</li><li>
The employee must be able to lift and/or move using proper body mechanics and agree to ask for assistance if required.</li><li>
While performing the duties of this job, the employee is frequently required to stand, walk, and sit.</li><li>
Must submit to random drug screenings.</li></ul>
Full-Time Benefit Perks:<ul><li>
Health benefits start on the first of the month after hire</li><li>
Medical, dental, and vision plans with sliding-scale premiums</li><li>
100% coverage for preventive health services</li><li>
HSA and FSA options available</li><li>
Company-paid life insurance and long-term disability</li><li>
401(k) with contributions starting after 30 days</li><li>
100% match on the first 4%,
</li><li>Full vesting after 3 years</li><li>
Access to exclusive employee discounts on travel, fitness, shopping, and more</li><li>
Paid Time Off</li><li>
Paid Holiday</li></ul>
Join us and make a significant impact on our company&rsquo;s success in reaching our target audience and driving business growth.</div>

CREDENTIALING SPECIALIST

Speak Viral

We are looking for a Credentialing Specialist to join our team and oversee administrative tasks dealing with our health facility&rsquo;s credentialing.Credentialing Coordinator responsibilities include maintaining and verifying files and tracking the expiration of certifications throughout the organization.Ultimately, you will work with different departments across our organization to ensure staff members have the necessary accreditations needed throughout the year.Responsibilities<ul><li>Identify discrepancies in information and conduct follow-ups</li><li>Present applications to the facility&rsquo;s Credentialing Committee</li><li>Assist customers with credentialing inquiries</li><li>Respond to health plan provider inquiries</li><li>Capture primary source documentation in computer databases</li><li>Ensure data is backed up</li><li>Follow compliance laws, regulations, procedures, and policies</li></ul>Requirements and skills<ul><li>Proven work experience as a Credentialing Coordinator or similar role</li><li>Excellent verbal and written communication skills</li><li>Expertise with Microsoft Office Word and Excel</li><li>Proficient touch-typing skills</li><li>Ability to focus for extended periods</li><li>Relevant training and/or certifications as a Credentialing Coordinator</li></ul>Benefits: Increment after Probation Annual Increment Free Meal/Tea Career GrowthJob Type: Full-timePay: Rs50,000.00 - Rs100,000.00 per monthApplication Question(s):<ul><li>Will you be able to work in night shift(7pm to 4am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

Credentialing Specialist

Ayzel Global

Company OverviewMedBillz is a US-focused medical billing and revenue cycle management company that helps healthcare providers improve compliance, reduce claim denials, and streamline payer enrollment processes.This role is being hired and managed through Ayzel Global, supporting MedBillz&rsquo;s growing US provider base.Role OverviewWe are seeking a Medical Credentialing Specialist with hands-on experience in US provider enrollment and payer credentialing. The role requires managing end-to-end credentialing workflows, ensuring compliance with payer and regulatory requirements, and working closely with billing and operations teams to prevent revenue disruptions.This is a detail-intensive role suited for professionals who understand the administrative and compliance side of US healthcare systems.Key Responsibilities<ul><li>Manage end-to-end provider credentialing and re-credentialing processes</li><li>Enroll providers with Medicare, Medicaid, and commercial payers</li><li>Complete and maintain CAQH profiles (attestation, updates, audits)</li><li>Track credentialing timelines, expirations, and renewals</li><li>Communicate with insurance payers to resolve credentialing issues</li><li>Maintain accurate credentialing records and documentation</li><li>Coordinate with billing teams to ensure claims readiness post-credentialing</li><li>Ensure compliance with US healthcare regulations and payer requirements</li><li>Support audits and credentialing-related inquiries</li></ul>Required Qualifications<ul><li>1&ndash;3+ years of experience in US medical credentialing or provider enrollment</li><li>Hands-on experience with CAQH, Medicare, Medicaid, and commercial payers</li><li>Strong understanding of US healthcare credentialing workflows</li><li>Excellent attention to detail and documentation skills</li><li>Strong written and verbal English communication</li><li>Ability to manage multiple providers and deadlines simultaneously</li></ul>Preferred Skills (Nice to Have)<ul><li>Experience working with US medical billing or RCM companies</li><li>Familiarity with EHRs, practice management systems, or credentialing software</li><li>Experience credentialing across multiple specialties</li><li>Prior experience working with US clients or offshore healthcare teams</li></ul>What We Offer<ul><li>Full-time, stable role within a growing US healthcare services company</li><li>Competitive salary (based on experience)</li><li>Exposure to US healthcare compliance and payer systems</li><li>Structured processes and long-term growth opportunities</li><li>Supportive, systems-driven work environment</li></ul>Work Type<ul><li>Work Type: Full-time</li><li>Location: On-site / Remote (as per company policy)</li><li>Client: US Healthcare Company (MedBillz)</li></ul>Job Type: Full-timePay: Rs85,000.00 - Rs125,000.00 per monthWork Location: In person

Medical Credentialing Specialist

Worldwide Medical Staffing

We are actively seeking a full-time HR/Credentialing Specialist in Mesa AZ!
 
About the Job
 
Worldwide Medical Staffing
 Location: Mesa, AZ
 Employment Type: Full-Time
 
About Worldwide Medical Staffing: 
Worldwide Medical Staffing is a trusted provider of healthcare professionals across federal, tribal, and commercial healthcare systems. We take pride in delivering highly qualified clinicians through a streamlined, high-quality recruiting and credentialing process. Our team values communication, accuracy, teamwork, and exceptional service to our providers and clients.
 
Position Overview: 
The HR/Credentialing Specialist plays a critical role in ensuring our healthcare professionals meet all compliance, onboarding, and credentialing requirements. This role works closely with recruiters, providers, and client facilities to maintain accurate documentation and move candidates efficiently through each stage of the onboarding process.
 
This is a high-communication, detail-focused position perfect for someone who thrives in a structured environment and enjoys supporting a fast-paced recruitment team.
 
Credentialing & Compliance: 
<ul>
<li>Collect, review, and verify all required documents (licenses, certifications, education, background checks, immunizations, skills checklists, etc.).</li>
<li>Manage and maintain candidate files in accordance with facility, state, and federal regulations.</li>
<li>Monitor expiring credentials and ensure timely renewals.</li>
<li>Prepare and submit complete credentialing packets to facilities.</li>
<li>Maintain strict accuracy and confidentiality of all provider files.</li>
</ul>
Internal Communication & Coordination: 
<ul>
<li>Work closely with recruiters to ensure candidates stay on track during onboarding.</li>
<li>Provide status updates to recruitment manager regarding candidate progress, missing requirements, and roadblocks.</li>
<li>Coordinate with compliance teams, HR, and payroll to ensure documentation is in order.</li>
<li>Become the Subject Matter Expert on benefits for internal and external employees.</li>
<li>Communicate clearly with candidates regarding required documents, timelines, and onboarding instructions.</li>
</ul>
Required Qualifications: 
<ul>
<li>1–3 years of experience in healthcare credentialing, HR onboarding, compliance, or a related field (medical staffing experience preferred).</li>
<li>Strong understanding of credentialing requirements (BLS/ACLS, licenses, immunizations, background checks, etc.).</li>
<li>Excellent communication skills — written, verbal, and professional phone etiquette.</li>
<li>High attention to detail and accuracy in document review.</li>
<li>Strong organizational skills with the ability to manage multiple candidates at once.</li>
<li>Proficiency in Microsoft Outlook, Excel, and data entry systems.</li>
<li>Ability to work independently while supporting a collaborative team environment.</li>
</ul>
Preferred Qualifications: 
<ul>
<li>Experience with healthcare staffing ATS/credentialing systems (e.g., UltraStaff, Taleo, ADP.).</li>
<li>Knowledge of Joint Commission standards or federal medical staffing compliance.</li>
<li>Prior experience working in a fast-paced recruiting or medical staffing environment.</li>
</ul>
What We Offer: 
<ul>
<li>Competitive compensation.</li>
<li>Medical, dental, and vision benefits.</li>
<li>PTO + paid holidays.</li>
<li>Opportunities for growth within the HR and credentialing departments.</li>
<li>Supportive team environment.</li>
<li>Mission-driven work supporting healthcare facilities nationwide.</li>
</ul>
About Worldwide Medical Staffing
 
WorldWide Medical Staffing is a Native-American, Veteran-owned small business that was established in 1993. Worldwide Medical Staffing provides multidisciplinary staffing support in all clinical disciplines including emergency medicine, critical care, surgical services, occupational medicine, behavioral health and primary care. Our mission is to be the leading provider of healthcare personnel for government facilities across the country. We create a customized experience for each person we place, understanding how to create solutions for our clients. Join us in making a positive impact on patient care.

HR/Credentialing Specialist

Behavioral Health Group

<div>Remote Position - Requires Payor Credentialing and Payor Enrollment experience

The Payor Credentialing Specialist is responsible for leading, coordinating, monitoring, and maintaining the payor and provider credentialing and re-credentialing processes. Facilitates all aspects of BHG&rsquo;s payor credentialing including payor enrollments, revalidations, maintenance, license updates, and follow up on payor credentialing related A/R issues. Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to payor credentialing and enrollment. Responsible for the accuracy and integrity of the credentialing database system and related applications. Works under the supervision of the Director of Payor Credentialing in conjunction with Chief Revenue Officer.

The key responsibilities of the Payor Credentialing Specialist include but not limited to:

Duties and Responsibilities
<ul>
<li>Prompt and regular attendance at an assigned work location.</li>
<li>Ability to complete or oversee the completion of assigned tasks/projects in a timely manner.</li>
<li>Complete process to enroll and credential facilities as well as providers with insurances; ensure all payor criteria are met.</li>
<li>Leads, coordinates, and monitors the collection, review, and analysis of payor enrollment applications.</li>
<li>Responsible for accuracy and completeness of payor enrollment submissions including supporting documentation.</li>
<li>Follow up with providers and insurances for timely credentialing and enrollment process(es).</li>
<li>Responsible for monitoring application progress and following up with payors as needed until confirmation of credentialing and network load is complete.</li>
<li>Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow-up.</li>
<li>Review, and update if necessary; health plan directories, agencies, and other appropriate entities for current and accurate provider information</li>
<li>Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and enrollment issues as they arise.</li>
<li>Utilizes the credentialing database, optimizing efficiency, and performs query, report and document generation.</li>
<li>Enters and maintains accuracy of data input into Credential Stream, PECOS, NPPES, CAQH, Optum, Availity, and other payor portals.</li>
<li>Verify provider accuracy in payor directories.</li>
<li>Provide support with managed care delegated credentialing audits; conduct internal file audits.</li>
</ul>
Regulatory
<ul>
<li>Ensure compliance with regulatory bodies (Joint Commission, NCQA, URAC, CMS, federal and state laws) and policies and procedures in all aspects of the payor credentialing process.</li>
</ul>
Marketing and Outreach
<ul>
<li>Participate in community and public relations activities as assigned.</li>
</ul>
Professional Development
<ul>
<li>Demonstrates the belief that addiction is a brain disease, not a moral failing.</li>
<li>Demonstrates hope, respect, and caring in all interactions with patients and fellow team members.</li>
<li>Establishes and maintains positive, professional relationships in the workplace.</li>
<li>Ability to work independently and under deadlines while handling multiple tasks simultaneously.</li>
<li>Makes decisions and uses good judgment with confidential and sensitive issues.</li>
<li>Maintain professional, calm demeanor with others in stressful or other undesirable situations.</li>
</ul>
Training
<ul>
<li>Attend and complete all required trainings as assigned by Director.</li>
<li>Prompt and regular attendance at an assigned work location.</li></ul> 


Minimum Requirements
<ul><li>The Credentialing Administrator needs at least 3 to 5 years of experience in payor credentialing/enrollment experience.</li>
</ul>
Qualifications
<ul>
<li>Bachelor&rsquo;s degree preferred or comparable work experience.</li>
<li>Current CPCS or CPMSM certification or working towards certifications.</li>
<li>Experience or working knowledge of full credentialing cycles; initial payor credentialing/enrollment, maintenance and revalidation.</li>
<li>Experience or working knowledge of CredentialStream credentialing platform or other credentialing database software.</li>
<li>Excellent attention to detail, problem-solving, critical thinking, and analytical skills.</li>
<li>Strong working knowledge of word processing, spreadsheets, data entry, database experience and other computer related skills.</li></ul> 


In addition to meeting the qualifications, the ideal candidate will embody the following characteristics and possess the knowledge, skills and abilities listed below:
<ul>
<li>Holds a basic understanding of substance use disorder.</li>
<li>The highest ethical and professional standards.</li>
<li>Maintains the strictest confidentiality.</li>
<li>Excellent written and verbal communication skills.</li>
<li>Excellent attention to detail and problem-solving skills required.</li>
<li>Excellent analytical, judgment, and decision-making skills.</li>
<li>Proficient in Adobe, Excel, PowerPoint, Word, Outlook, and other Microsoft Office applications.</li>
<li>Well organized, capable of juggling multiple projects and accustomed to tight deadlines.</li>
<li>Ability to work effectively and independently with both clinical and non-clinical colleagues.</li>
<li>Ability to perform research independently.</li></ul> 


Physical Requirements and Working Conditions
The physical demands described here are representative of the requirements that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions to the extent such accommodation does not create an undue hardship on the business.
<ul>
<li>Speaking and hearing ability sufficient to communicate effectively by phone or in person at normal volumes</li>
<li>Vision adequate to read correspondence, computer screen, forms, etc.</li>
<li>Sit for long periods of time, some bending, stooping and stretching</li>
<li>Variable workload, periodic high activity level</li>
<li>Keyboarding for long periods of time</li></ul> 


Disclaimer
The above statements are intended to describe the general nature and level of work being performed by team members assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of team members so classified. All team members may be required to perform duties outside of their normal responsibilities from time to time, as needed, and this job description may be updated at any time.

BHG is an equal opportunity, affirmative action employer providing equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law.
Equal Opportunity Employer 
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.</div>

Payor Credentialing Specialist (remote)

MeshSquare

Job description:Position: Senior Credentialing SpecialistCompany: Meds NexusLocation: Office # 1st, 5th Floor, Gold Mark Plaza, Asghar Mall Rd, Asghar Mall Scheme, Rawalpindi, Punjab 46000Job Timing: 06:00 PM To 03:00 AM (EVENING SHIFT)Job Type: Night ShiftExperience Required: 2-3 yearsPosition Available: 2Special Note: This job is not for fresh candidates.About Us:Meds Nexus is a leading medical billing company based in Rawalpindi, dedicated to streamlining healthcare financial processes. We are actively seeking a detail-oriented and motivated individual to join our Credentialing team as a Senior Credentialing Specialist.Key Responsibilities:- Accurately complete credentialing and reappointment applications for Outpatient and ABA providers.- Track progress of applications and report to Client Managers/Team Leaders.- Monitor and update provider portals for accurate information.- Maintain current provider records electronically and in hard copy folders.- Assist in obtaining required documentation from providers.- Prepare professional communication to providers, payers, and facilities.- Understand the impact of credentialing on billing, contracts, and EDI.- Investigate and determine solutions to problems.- Communicate clearly and professionally with team members, payers, and credentialing representatives.- Process ERA &amp; EFT applications.- Have brief knowledge of Government, MCOs, and commercial insurance enrollments.Salary Package:- Basic: up to Rs.100,000 per monthJob Rewards and Benefits:- Paid Leaves- HR Bonus- Loan Policy- Advance Salary- Yearly Loyalty Rewards- Leave Encashment- Inflation Bonus- Promotion- Increments- Medical (TBD)- Employee Equity Funds Program (EEFP)- Saturday and Sunday Off- Complementary Food (Dinner) &amp; Tea/Green Tea (Two times)How to Apply:If you are ready to contribute to a dynamic team and take the next step in your finance career, please submit your resume and a cover letter outlining your relevant experience to hr@medsnexus.com. Please include &quot;Account Assistant Application&quot; in the subject line.Application Deadline: On an urgent basisMeds Nexus is an equal-opportunity employer. We encourage applications from candidates of all backgrounds and experiences.Contact Information:- Email: hr@medsnexus.com- Phone: 051 889-2889 WhatsApp: 03708892889Job Type: Full-timePay: Rs100,000.00 - Rs150,000.00 per monthWork Location: In person

Senior Credentialing Specialist (Medical Billing)

GRMAC Pvt ltd

Job Title: Credentialing Executive (Healthcare Process)Location: Chennai Experience: 1&ndash;5 years Industry: Health Care / Medical ServicesJob Description: Responsible for verifying and processing healthcare professionals&rsquo; credentials, licenses, and documents as per company and client standards. Ensure accuracy and timely completion of credentialing and re-credentialing activities.Key Responsibilities:<ul><li>Collect and verify doctors&rsquo;/providers&rsquo; documents and licenses</li><li>Update and maintain credentialing databases</li><li>Coordinate with healthcare providers and insurance networks</li><li>Ensure compliance with regulatory and organizational policies</li></ul>Requirements:<ul><li>Good communication skills</li><li>Attention to detail</li><li>Basic knowledge of healthcare documentation preferred</li><li>Experienced candidates can apply</li></ul>Job Types: Full-time, PermanentPay: ₹20,000.00 - ₹30,000.00 per monthBenefits:<ul><li>Health insurance</li><li>Provident Fund</li></ul>Work Location: In person

Credentialing Specialist (Healthcare Process)

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