Remote Maryland Credentialing Specialist – Healthcare

Elevate Calls Inc.; Manila; On-site; PHP 3,699,000 - 4,624,000; Full time

Job summary

Elevate Calls Inc. is a remote-friendly company seeking a Credentialing Specialist to oversee Maryland healthcare credentialing and enrollment for providers working remotely. You will manage applications, renewals, data accuracy, and deadlines to ensure regulatory and payer compliance.

The role requires experience with CAQH, PECOS, and NPPES, with a strong focus on Maryland Medicaid and regional payers. Excellent communication and meticulous attention to detail are essential.

Qualifications

• Experience in healthcare credentialing or provider enrollment, preferably Maryland-based.
• Familiarity with Maryland Medicaid and regional payers.
• Proficiency with CAQH, PECOS, and NPPES.
• Familiarity with EPREP Portal.
• Attention to detail and ability to manage multiple deadlines.
• Strong written and verbal communication; professional in interactions.
• Self-motivated and reliable in remote work environment.

Responsibilities

• Manage credentialing and recredentialing for Maryland-based providers (physicians, NPs, allied health).
• Ensure provider files comply with Maryland state regulations, insurance guidelines, and accreditation standards.
• Submit credentialing applications and enrollment forms to commercial payers, Medicaid, and Medicare (PECOS).
• Maintain provider data in CAQH, NPPES, and internal databases.
• Track expirable items: licenses, certifications, recredentialing deadlines.
• Communicate with insurance companies, government agencies, and internal teams to resolve issues.
• Stay updated on Maryland payer requirements and healthcare regulations.
• Conduct background checks and verify credentials to maintain provider profiles.

Skills

Healthcare credentialing

Maryland focus

Attention to detail

Communication skills

Remote work

Tools

CAQH

PECOS

NPPES

EPREP Portal

Job description

Elevate Calls Inc. is a remote-friendly company seeking a Credentialing Specialist to oversee Maryland healthcare credentialing and enrollment for providers working remotely. You will manage applications, renewals, data accuracy, and deadlines to ensure regulatory and payer compliance.

The role requires experience with CAQH, PECOS, and NPPES, with a strong focus on Maryland Medicaid and regional payers. Excellent communication and meticulous attention to detail are essential.