
Maryland Healthcare Credentialing Expert
1 week ago
Credentialing Professional
Job DescriptionElevate Calls Inc. is seeking a Credentialing Specialist with experience in Maryland healthcare credentialing to join our growing remote team.
This role involves managing the credentialing and recredentialing processes for Maryland-based healthcare providers, including physicians, nurse practitioners, and allied health professionals.
The successful candidate will ensure all provider files comply with Maryland state regulations, insurance guidelines, and national accreditation standards.
Responsibilities include:
- Managing credentialing applications and enrollment forms to commercial payers, Medicaid, and Medicare (via PECOS).
- Maintaining and updating provider data in credentialing systems such as CAQH, NPPES, and internal databases.
- Tracking and monitoring expirable items such as licenses, certifications, and recredentialing deadlines.
Additional responsibilities include communicating professionally with insurance companies, government agencies, and internal departments to resolve credentialing-related issues.
The ideal candidate will stay up to date with Maryland payer requirements, credentialing laws, and healthcare regulations.
QualificationsThe following qualifications are required for this position:
- Prior experience in healthcare credentialing or provider enrollment, preferably with Maryland-based providers.
- Familiarity with Maryland-specific credentialing standards, including Maryland Medicaid and regional payers (e.g., CareFirst, Maryland Physicians Care).
- Proficiency with credentialing platforms such as CAQH, PECOS, and NPPES.
- Demonstrated commitment to confidentiality and compliance with healthcare regulations.
The ideal candidate will possess exceptional attention to detail and be able to manage multiple deadlines effectively.
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