Certified Healthcare Provider Administrator

2 days ago

Pasay, National Capital Region, Philippines beBeeCredentialing Full time $74,900 - $101,400
Credentialing Specialist Job Description

The Credentialing Specialist oversees the credentialing and enrollment processes for healthcare providers in Maryland. This role requires attention to detail, excellent communication skills, and proficiency with credentialing platforms.

  • Manage the credentialing and recredentialing processes for healthcare providers in Maryland.
  • Ensure provider files comply with state regulations, insurance guidelines, and national accreditation standards.
  • Complete and submit credentialing applications and enrollment forms to commercial payers, Medicaid, and Medicare via PECOS.
  • Maintain and update provider data in credentialing systems such as CAQH, NPPES, and internal databases.
  • Track expirable items like licenses, certifications, and recredentialing deadlines.
  • Communicate professionally with insurance companies, government agencies, and internal departments to resolve credentialing issues.

This position requires a strong understanding of Maryland-specific credentialing standards and experience working with credentialing platforms.

A successful candidate will be self-motivated, reliable, and able to work effectively in a remote environment.

Elevate your career with our dynamic work environment, opportunities for growth, and competitive compensation package.

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