Credentialing Specialist

ZMark Health, LLC.; Middletown Township, Northern (PA, KY); Hybrid; USD 42,000 - 68,000; Full time

Job summary

ZMark Health, LLC. in Middletown, PA is seeking a Credentialing Specialist to manage the full credentialing and enrollment lifecycle for healthcare providers.

You will ensure timely enrollment with Medicare, Medicaid, managed care and private payers, while maintaining payer data and supporting client service. The role requires 3–5 years of experience in billing, managed care or healthcare, and strong MS Office skills.

Qualifications

• MS Office proficiency for data entry, reporting, and documentation.
• Excellent interpersonal, written and verbal communication skills.
• Ability to work with minimal supervision and manage multiple tasks.

Responsibilities

• Complete and submit enrollments with Medicare, Medicaid, Managed Care and Private Insurance payers.
• Maintain practitioner data in the Provider Data Management platform (exydoc).
• Compile application information and attachments for enrollments.
• Maintain a Master List of enrolled payers and renewal dates.
• Collaborate with client reimbursement personnel to resolve credentialing denials.

Skills

MS Office

Interpersonal communication

Verbal communication

Written communication

Education

High School Diploma or GED

Job description

Are you a detail-oriented healthcare professional who thrives in a fast-paced environment and enjoys navigating the complexities of insurance enrollment and provider credentialing? We are seeking a highly organized and motivated Credentialing Specialist to join our growing team in Middletown, PA.

In this critical role, you will be responsible for managing the full credentialing and enrollment lifecycle for healthcare providers, ensuring accurate and timely enrollment with Medicare, Medicaid, managed care organizations, and commercial insurance payers. Your work will directly support provider reimbursement, operational efficiency, and exceptional client service.

Please Note: This position is on-site at our office in Middletown, PA.

General Responsibilities:

• Complete and submit all enrollments with all applicable Medicare, Medicaid, Managed Care and Private Insurance payers
• Maintain all practitioner and related data in our Provider Data Management platform called exydoc
• Compile all necessary application information and attachments
• Maintain a Master List of all enrolled payers and renewal dates
• Work with client reimbursement personnel to ensure all applicable payers are enrolled as well as to resolve any claim denials associated with credentialing
• Track and manage applications thru the approval process
• Maintain all needed practice details for successful enrollment
• Responsible for providing high quality service to all clients as it relates to credentialing
• Promote ZMark Health services to existing and prospective clients
• Ensure effective communication with both internal and external stakeholders
• Interact daily with client team members to ensure accurate transfer of information
• Initiate communication with payers on behalf of our clients
• Document all interaction with payers
• Adhere to all company policies and procedures
• Conduct business in a safe, compliant and secure manner as it relates to HIPAA and patient privacy
• Other duties as assigned

Position Requirements:

• High School Diploma or GED Required
• 3-5 years of experience in a Billing, Managed Care or Healthcare Environment
• Working Knowledge of MS Office
• Excellent interpersonal, written and verbal communication skills
• Must be able to work with minimal supervision
• Utilize effective time management principles, as well as work on multiple tasks simultaneously
• Demonstrated respect for confidentiality and compliance standards
• Ability to communicate effectively with staff at all levels as well as external stakeholders

If you are a motivated professional with a passion for accuracy, compliance, and client service, we encourage you to apply and become an essential part of our team.