Job Description
Credentialing Specialist – Work From Home (Full-Time)
Role Overview (In Simple Terms)
We are hiring experienced Credentialing & Enrollment Specialists who can handle the entire process of enrolling healthcare providers with insurance companies . This is a permanent work-from-home role and requires strong attention to detail, good communication, and the ability to manage multiple applications independently.
What You’ll Be Doing
- Manage end-to-end provider credentialing and insurance enrollment for individual and group providers.
- Submit and track enrollment applications across all US states.
- File Letters of Interest (LOIs) and follow up with insurance payers via calls and emails.
- Work with private insurance, Medicare, Medicaid, Medicaid MCOs, and Medicare Advantage plans .
- Maintain and update provider profiles on portals like:
- CAQH
- PECOS
- Availity
- Navinet
- NPPES
- Apply for and renew provider licenses such as:
- Professional licenses
- DEA
- Controlled Substance licenses
- Ensure provider information and documents are always accurate and up to date.
- Regularly update clients on application status and ensure providers remain active with payers.
- Work independently while staying highly engaged with the remote team.
Must-Have Requirements
- Minimum 2 years of hands-on experience in provider credentialing and enrollment.
- Strong understanding of documents required for individual and group enrollments .
- Proven experience handling payer communication and follow-ups .
- Comfortable managing multiple applications with accuracy and deadlines .
- Excellent organization and time-management skills.
- Strong written and verbal communication skills for remote work.
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