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Credentialing Specialist

πŸ•’ 4 days ago
Provider CredentialingPayer EnrollmentRecredentialingCAQH
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πŸ“œ Description

  • Review provider records in Medallion and maintain profiles, attestations, and documentation in CAQH.
  • Assist clinicians with NPI applications, updates, fingerprinting, and other credentialing documentation.
  • Monitor licenses, certifications, expirations, payer rosters, applications, renewals, and enrollment status.
  • Communicate with clinicians, insurers, and internal teams to obtain information and resolve discrepancies.
  • Maintain confidential credentialing records and support administrative and compliance-related tasks.

πŸ› οΈ Requirements

  • High school diploma or equivalent preferred.
  • Previous experience in medical office administration, healthcare credentialing, provider enrollment, or a related healthcare administrative role preferred.
  • Familiarity with CAQH, NPI applications, insurance credentialing, and payer enrollment processes preferred.
  • Ability to review and interpret provider credentialing records in electronic platforms, including Medallion or similar systems.
  • Strong attention to detail, organizational skills, and ability to manage multiple deadlines.
  • Excellent written and verbal communication skills.
  • Proficiency in Microsoft Office applications and electronic recordkeeping.
  • Ability to work independently in a remote setting while maintaining strong communication and accountability.
  • Commitment to protecting confidential provider and patient information.

✨ Benefits

  • Medical
  • Dental
  • Vision insurance
  • Paid time off (PTO) and paid holidays
  • 401(k) retirement plan
  • Professional development and growth opportunities
  • A collaborative and supportive team environment
  • Full-time remote work
  • Coordinate provider and facility credentialing, recredentialing, and enrollment with Medicare, Medicaid, and commercial insurance payers.
Full job description

Credentialing Specialist | Full-Time | Remote

Join Our Team at H2 Health!

H2 Health is seeking a detail-oriented and highly organized Credentialing Specialist to join our team in a full-time, remote position!

In this role, you will support our growing healthcare organization by coordinating provider credentialing, insurance payer enrollments, and recredentialing processes. You'll help ensure our physical, occupational, and speech therapy providers maintain accurate and up-to-date credentials so they can continue delivering exceptional patient care.

We're looking for someone who thrives in a detail-driven environment, takes initiative, and enjoys collaborating with clinicians and internal teams.

Responsibilities

  • Coordinate provider and facility credentialing, recredentialing, and enrollment processes with insurance payers, including Medicare, Medicaid, and commercial insurance plans.
  • Review credentialing information available through Medallion, verifying provider details, credentialing status, and supporting documentation for accuracy and completeness.
  • Maintain and update provider profiles in the Council for Affordable Quality Healthcare (CAQH) system, including required attestations and supporting documentation.
  • Assist clinicians with National Provider Identifier (NPI) applications and updates.
  • Monitor professional licenses, certifications, expiration dates, and other required credentialing documentation.
  • Ensure newly hired providers are added to applicable insurance payer rosters and terminated providers are removed as required.
  • Track credentialing applications, renewals, outstanding documentation, and payer enrollment status to support timely completion.
  • Communicate with clinicians, insurance representatives, and internal departments to obtain information and resolve credentialing discrepancies.
  • Assist clinicians with fingerprinting and other documentation required for credentialing.
  • Maintain confidential, accurate, and organized credentialing records in accordance with applicable regulations and company policies.
  • Support additional administrative and compliance-related tasks as needed.

Requirements

  • High school diploma or equivalent preferred.
  • Previous experience in medical office administration, healthcare credentialing, provider enrollment, or a related healthcare administrative role preferred.
  • Familiarity with CAQH, NPI applications, insurance credentialing, and payer enrollment processes preferred.
  • Ability to review and interpret provider credentialing records in electronic platforms, including Medallion or similar systems.
  • Strong attention to detail, organizational skills, and ability to manage multiple deadlines.
  • Excellent written and verbal communication skills.
  • Proficiency in Microsoft Office applications and electronic recordkeeping.
  • Ability to work independently in a remote setting while maintaining strong communication and accountability.
  • Commitment to protecting confidential provider and patient information.

Benefits

At H2 Health, we value our team members and are committed to supporting their professional and personal well-being.

As a full-time employee, you'll have access to:

  • Medical, dental, and vision insurance
  • Paid time off (PTO) and paid holidays
  • 401(k) retirement plan
  • Professional development and growth opportunities
  • A collaborative and supportive team environment
  • Full-time remote work

Why H2 Health?

At H2 Health, our mission is to make a meaningful difference in the lives of the patients and communities we serve. Behind every great clinician is a dedicated team working to ensure they have the support they need to succeed.

We foster a culture of collaboration, accountability, and continuous improvement, where every team member plays an important role in our success.

Ready to Join Our Team?

If you're organized, detail-oriented, and passionate about supporting healthcare professionals, we'd love to hear from you!

Apply today and Dare to Make a Difference with H2 Health!

H2 Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to any legally protected status.

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