Credentialing Specialist_Maryland HealthCare Providers

4 days ago

Manila, National Capital Region, Philippines Elevate Calls Inc. Full time ₱800,000 - ₱1,200,000 per year

Company Description

Job Title:
 Credentialing Specialist Maryland Healthcare Providers

Company:
 Elevate Calls Inc.

Location:
 Remote (Permanent Work From Home Position)

Position Overview

Elevate Calls Inc. is seeking a 
Credentialing Specialist
 with experience in 
Maryland healthcare credentialing
 to join our growing remote team. In this role, you will oversee the credentialing and enrollment processes for healthcare providers practicing in Maryland. Your work will be essential in ensuring compliance with state and federal regulations, as well as specific payer requirements.

Key Responsibilities

  • 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
    .

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
, wed love to hear from you. Please send your resume to 

 with the subject line:

Credentialing Specialist Maryland

  • We look forward to reviewing your application

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