Credentialing Expert

4 days ago

Province of Palawan, Mimaropa, Philippines beBeeCredentialing Full time $60,000 - $90,000

We are seeking a highly skilled Credentialing Professional to oversee the credentialing and enrollment processes for healthcare providers in Maryland.

Job Description:

The ideal candidate will have prior experience in healthcare credentialing or provider enrollment, preferably with Maryland-based providers. They will be responsible for managing the credentialing and recredentialing processes, ensuring compliance with Maryland state regulations, insurance guidelines, and national accreditation standards.

  • Manage credentialing and recredentialing processes for Maryland-based healthcare providers
  • Ensure provider files comply with Maryland state regulations, insurance guidelines, and national accreditation standards
  • Complete and submit credentialing applications and enrollment forms to commercial payers, Medicaid, and Medicare (via PECOS)
Key Qualifications:

To excel in this role, you will need:

  • 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
  • Proficiency with credentialing platforms such as CAQH, PECOS, and NPPES
  • Familiarity with the EPREP Portal, including provider registration and compliance functions
  • Exceptional attention to detail and ability to manage multiple deadlines effectively
  • Strong written and verbal communication skills; professional in interactions with internal and external stakeholders
  • Self-motivated and reliable in a fully remote work environment
  • Demonstrated commitment to confidentiality and compliance with healthcare regulations

This is an excellent opportunity to leverage your expertise in healthcare credentialing and join a team of dedicated professionals.

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