Credentialing Specialist

2 days ago

Angeles City, Central Luzon, Philippines beBeeCredentialing Full time ₱1,455 - ₱8,900
Credentialing Professional - Remote Opportunity

We are seeking a skilled Credentialing Professional to join our team in a remote capacity. As a key member of our organization, you will be responsible for ensuring compliance with state and federal regulations as well as specific payer requirements.

  • Oversee the credentialing and enrollment processes for healthcare providers practicing in Maryland.
  • Manage provider files to ensure compliance 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.
  • Stay up-to-date with Maryland payer requirements, credentialing laws, and healthcare regulations.
Requirements:
  • 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, 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.

This is a fantastic opportunity for a motivated and experienced Credentialing Professional to join our team in a remote capacity. If you have the required skills and qualifications, we encourage you to apply.

Job Type:

Full-time

Seniority Level:

Associate

Industries:

Healthcare

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