Senior Credentialing Specialist (Permanent Work-From-Home)

Senior Credentialing Specialist (Permanent Work-From-Home)

About the Role:

Key Responsibilities:

• Manage the full spectrum of provider credentialing and enrollment, including filing Letters of Interest and completing enrollment applications for all states.
• Engage with payers via calls and emails to ensure the successful processing of both individual and group applications.
• Demonstrate expertise in submitting required documentation for private commercial payors, Medicare, Medicaid, Medicaid MCO, and Medicare supplement/replacement plans.
• Maintain regular communication with clients, providing updates and ensuring the active status of providers with payers.
• Handle end-to-end processes for creating and maintaining provider details on platforms such as CAQH, PECOS, Availity, Navinet, NPPES, and other provider portals.
• Manage the application and renewal process for all provider licenses, including Professional, DEA, and Controlled Substance licenses.
• Ensure continuous updating and maintenance of client and application data, readily available for client requests.

Requirements:

• A minimum of 5 years of experience in provider credentialing and enrollment.
• Strong organizational skills and the ability to work independently in a remote setting.
• Proficiency in using credentialing portals and managing the associated documentation.
• Exceptional communication skills to effectively engage with both clients and payers.

Mandatory Requirements:

• Has a fast dedicated laptop/PC I5+, 8GB Ram, Windows 10/11 (licensed and activated), MS Office 2013 + (working copy).
• Quiet home office with no distractions
• Have at least 1 year of experience working from home successfully during EST hours
• Minimum dedicated fast internet 50MB+ (must be fiber or cable into your home)
• 9am-6pm EST Mon-Fri shift.

Compensation: