Healthcare Credentialing Expert

4 days ago

Makati City, National Capital Region, Philippines beBeeCredentialing Full time $80,000 - $120,000
Credentialing Specialist

Establish a career in credentialing by assuming the role of Credentialing Specialist. This position is ideal for professionals seeking to excel in Maryland healthcare credentialing.

  • Manage the credentialing and recredentialing processes for Maryland-based healthcare providers, 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 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.

This position requires exceptional attention to detail, strong written and verbal communication skills, and the ability to manage multiple deadlines effectively.

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