Healthcare Credentialing Professional

23 hours ago

Marikina City, National Capital Region, Philippines beBeeCredentialing Full time $80,000 - $100,000

We are seeking a skilled Credentialing Specialist to join our remote team. The successful candidate will be responsible for overseeing the credentialing and enrollment processes for healthcare providers practicing in Maryland. This is an exciting opportunity to work in a fast-paced environment and contribute to the growth of our company.

  • Manage the credentialing and recredentialing processes for Maryland-based healthcare providers, including physicians, nurse practitioners, and allied health professionals.
  • Evaluate and ensure compliance with Maryland state regulations, insurance guidelines, and national accreditation standards.
  • Prepare 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.
  • Stay up to date with Maryland payer requirements, credentialing laws, and healthcare regulations.
  • Conduct background checks, verify credentials, and maintain accurate, complete provider profiles.

To be considered for this role, you must have prior experience in healthcare credentialing or provider enrollment, preferably with Maryland-based providers. You should also be familiar 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 is essential. Additionally, you should be able to work effectively in a fully remote work environment and have strong written and verbal communication skills.

Qualifications
  • 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.
  • Familiarity with the EPREP Portal (Maryland Emergency Preparedness and Response Portal), including provider registration and compliance functions.
  • Exceptional attention to detail and the ability to manage multiple deadlines effectively.
  • Strong written and verbal communication skills; professional in interactions with both internal and external stakeholders.
  • Self-motivated and reliable in a fully remote work environment.
  • Demonstrated commitment to confidentiality and compliance with healthcare regulations.
How to Apply

If you are a motivated credentialing professional with experience in Maryland healthcare, we would love to hear from you. Please submit your resume to [insert contact information]. We look forward to reviewing your application.

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