Credentialing Specialist

Remote Jobs; Jacksonville (FL); Remote; USD 42,000 - 64,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid time off and holidays

401(k) retirement plan

Professional development opportunities

Job summary

H2 Health is seeking a Credentialing Specialist for a full-time remote role to coordinate provider credentialing, enrollment, and recredentialing with Medicare, Medicaid, and commercial payers. You will support clinicians and internal teams while maintaining accurate credentialing records.

Ideal candidates have healthcare credentialing experience, strong attention to detail, and proficiency with CAQH and NPI applications.

Qualifications

• Strong attention to detail and organizational skills.
• Excellent written and verbal communication abilities.
• Familiarity with CAQH, NPI applications, payer enrollment processes.
• Ability to work independently in a remote setting.

Responsibilities

• Coordinate credentialing, recredentialing, and enrollment with payers including Medicare and Medicaid.
• Review credentialing data for accuracy in Medallion or similar systems.
• Maintain provider profiles in CAQH with attestations and documents.
• Assist clinicians with NPI applications and updates.
• Monitor licenses, certifications and credentialing documentation.
• Ensure updated provider records and payer rosters are accurate.

Skills

Attention to detail

Organizational skills

Communication skills

Remote work

Education

High school diploma or equivalent

Tools

CAQH

NPI applications

Medallion system

Microsoft Office

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.

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