Certified Healthcare Credentialing Professional

2 weeks ago

Porac, Philippines beBeeCredentialing Full time $74,170 - $111,830
Credentialing Specialist

Elevate your career with a challenging role overseeing credentialing and enrollment processes for healthcare providers in Maryland.

This position involves managing the credentialing and recredentialing processes for healthcare professionals, ensuring compliance with state and federal regulations, as well as specific payer requirements.

  • Manage the credentialing process for healthcare providers practicing in Maryland, including physicians, nurse practitioners, and allied health professionals.
  • 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.
  • 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 provider profiles.

Prior experience in healthcare credentialing or provider enrollment is required. Familiarity with Maryland-specific credentialing standards, including Medicaid and regional payers, is necessary. Proficiency with credentialing platforms such as CAQH, PECOS, and NPPES is essential.

A strong attention to detail, effective time management skills, and excellent written and verbal communication skills are necessary for this role. Self-motivation and reliability in a remote work environment are also essential.

Benefits of working with us:

  • We offer a competitive compensation package and opportunities for professional growth.
  • You will have the chance to work with a talented team of professionals who share your passion for delivering exceptional results.

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