Credentialing Specialist for Medical Billing

The Credentialing Specialist is responsible for Government and Commercial payer credentialing and enrollment. This position covers initial enrollment for new providers, CAQH application monitoring services as well as revalidation enrollment when needed. You will be working directly with insurance provider relations, insurance representatives, CAQH and our clients for enrollments as well as troubleshooting any enrollment issues that arise.

Required Experience:

• Excel/Word/Outlook
• Ability to multitask and take ownership of processes
• Self-motivated and works independently
• Tech savvy and able to navigate multiple computer screens and tasks
• Ability to work in a fast-paced environment with possible short deadlines
• Medicare and Medicaid Provider enrollments including revalidations
• Insurance website knowledge, PECOS, CAQH, Optum Pay, Availity Portal, etc.

Previous Experience Helpful (not necessary):

• Acknowledge of 1500 Claim Form
• Clearing House knowledge such as Availity RCM, Waystar
• Experience in a medical billing environment
• Qgenda or other credentialing software platform