Credentialing Specialist

Independent Practice Management Services Organization; United States; Remote; USD 50,000 - 70,000; Full time

Job summary

Independent Practice Management Services Organization is seeking a Credentialing Specialist for a fully remote, full-time role. You will manage provider credentialing, verify qualifications, and submit applications while ensuring compliance with payer and regulatory standards.

Responsibilities include Medicare enrollment support, maintaining credentialing records, and collaborating with providers, payers, and internal teams to resolve issues and improve workflows.

Qualifications

• Experience managing provider enrollment and verification processes.
• Knowledge of Commercial, Medicaid, Medicare and other payer requirements.
• Strong attention to accuracy and ability to manage multiple deadlines.

Responsibilities

• Verify provider qualifications and maintain credentialing records.
• Complete and submit credentialing applications and re-appointments.
• Ensure compliance with payer, regulatory, and organizational requirements.
• Support Medicare and payer enrollment activities and respond to inquiries.
• Improve credentialing workflows and documentation.

Skills

Credentialing expertise

Payer enrollment knowledge

Communication skills

Attention to detail

Regulatory familiarity

Remote work ability

Office tools proficiency

Education

Associate or Bachelor’s in healthcare administration or related field

Tools

Credentialing software

Job description

Company Description

Independent Practice Management Services Organization supports independent medical practices with a variety of services, including insurance contracting and credentialing.

Role Description

The Credentialing Specialist is a full-time remote role responsible for all aspects of provider and practice credentialing. On a day-to-day basis, this role verifies provider qualifications, maintains accurate credentialing records, completes and submits credentialing applications and ensures compliance with payer, regulatory, and organizational requirements. The Credentialing Specialist processes insurance, hospital and IPA/CIN applications and re-appointments, monitors expirations of licenses and certifications, and works closely with providers, payers, and internal teams to resolve credentialing issues promptly. This role also supports Medicare and other payer enrollment activities, responds to participant inquiries, and contributes to continuous improvement of credentialing workflows and documentation.

Qualifications

• Strong credentialing and medical staff credentialing skills, with experience managing provider enrollment and verification processes.
• Knowledge of Commercial, Medicaid, Medicare and other payer requirements, including enrollment, revalidation, and compliance standards.
• Effective communication and customer service skills to interact with providers, practice staff, payers, and internal stakeholders.
• Extremely high level of accuracy and attention to detail, with ability to manage multiple deadlines and maintain organized records.
• Familiarity with healthcare regulations, accreditation standards, and credentialing software or databases.
• Ability to work independently in a remote environment, exercise sound judgment, and maintain confidentiality of sensitive information.
• Proficiency with common office and collaboration tools (e.g., spreadsheets, document management, secure email systems).
• Preferred: Previous experience in a medical group, health system, or practice management organization; associate or bachelor’s degree in healthcare administration, business, or a related field.