
Maryland Healthcare Credentialing Professional
1 day ago
Elevate your career as a Credentialing Specialist, playing a vital role in the credentialing and enrollment processes for healthcare providers.
Key Responsibilities:- Oversee the credentialing and recredentialing processes for Maryland-based healthcare providers, ensuring compliance with state and federal regulations.
- Ensure all 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).
- Maintain and update provider data in credentialing systems such as CAQH, NPPES, and internal databases.
- Track and monitor expirable items such as licenses, certifications, and recredentialing deadlines.
- Communicate professionally with insurance companies, government agencies, and internal departments to resolve credentialing-related issues.
- 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 both internal and external stakeholders.
- Join our team of dedicated professionals in a remote work environment.
- This is an opportunity to apply your expertise and contribute to the success of our organization.
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