Credentialing Specialist

Job Description

Responsibilities: Manage Medicare credentialing and provider enrollment through PECOS . Verify and submit provider applications for Medicare, Medicaid, and private payers. Maintain and update CAQH profiles , ensuring accuracy and timely attestation. Track application status and follow up with payers until final approval. Communicate with insurance companies, Medicare Administrative Contractors (MACs), and regulatory bodies to ensure smooth enrollment. Ensure compliance with CMS regulations , payer policies, and healthcare credentialing standards. Must-Have Qualifications: 2+ years of experience in provider credentialing & payer enrollment (preferably with Medicare). Proficiency in PECOS , CAQH, and payer-specific enrollment portals. Strong understanding of Medicare and Medicaid enrollment processes . Excellent communication and follow-up skills . Ability to work in a hybrid work arrangement .