Credentialing Specialist — Hybrid/Remote (Mon-Fri)

Workit Health; Charlotte (NC); Hybrid; USD 29,000 - 40,000; Full time

Benefits offered by this job

Fully remote work

5 weeks PTO

11 paid holidays

Health, dental, vision insurance

401k + 4% matching

HSA

FSA

Parental Leave

Professional development

Job summary

Workit Health seeks a Credentialing Specialist to manage credentialing for providers in a hybrid clinic environment across Albany, NY; Charlotte, NC; Lakewood, WA; and Missoula, MT. The role oversees credentialing, licensure tracking, and payer directory accuracy.

You will process applications, verify details, maintain provider data, and collaborate with billing to resolve denials or authorizations. HIPAA expertise and CAQH familiarity are essential.

Qualifications

• 2-3 years of Billing and Credentialing experience.
• Deep knowledge of HIPAA standards of operations.
• Familiarity with major payer portals and CAQH management.
• Ability to communicate clearly via email, Slack, and face-to-face.
• Proven aptitude for collaboration inside and outside of the department.
• Ability to bring organization and precision to complex datasets.
• Ability to use technology at an appropriate level for the role.
• Access to consistent, high-speed internet access.
• Works independently and meets deadlines.

Responsibilities

• Follow and maintain credentialing & clinic licensure policies and protocols
• Ensures reports on the credentialing status of providers are up-to-date and accurate
• Ensures all clinic information is accurate within payor directories
• Processes applications, verifies information, researches application details, and ensures processes are accurate and completed promptly.
• Maintain up-to-date data for each provider in the credentialing database and online systems.
• Monitor staff credentials and licenses
• Work closely with the Credentialing Manager and billing staff to identify and resolve any denials or authorization issues related to provider credentialing.
• Complete revalidation requests issued by payers.
• Mantains positive and optimistic attitude
• Other tasks as assigned

Skills

Billing & Credentialing

HIPAA knowledge

Payer portals familiarity

CAQH management

Clear communication

Collaboration

Data organization

Independent work

Tools

CAQH management system

Job description

Workit Health seeks a Credentialing Specialist to manage credentialing for providers in a hybrid clinic environment across Albany, NY; Charlotte, NC; Lakewood, WA; and Missoula, MT. The role oversees credentialing, licensure tracking, and payer directory accuracy.

You will process applications, verify details, maintain provider data, and collaborate with billing to resolve denials or authorizations. HIPAA expertise and CAQH familiarity are essential.