Credentialing Specialist – Payer & Provider Access

SCA Health (India); Salem (OR); Presencial; USD 52.000 - 64.000; Jornada completa

Descripción de la vacante

SCA Health in the United States is hiring a Credentialing Specialist to manage the end-to-end provider credentialing with insurers, Medicare and Medicaid. You will maintain provider files, update CAQH records, coordinate licenses, and collaborate with practice and billing to resolve credentialing issues.

The role requires strong attention to detail, excellent communication, and extensive experience in medical office credentialing and privileging processes, with a focus on timely, accurate

Formación

• Minimum of a high school diploma or GED required.
• Undergraduate degree or equivalent experience preferred.
• 5+ years in medical practice business office roles, with 1–2 years supervising.

Responsabilidades

• Manage full credentialing cycle with insurance carriers.
• Maintain provider files with up-to-date information for government and commercial payers.
• Keep credentialing software accurate and updated.
• Update CAQH database files on CMS schedule.
• Coordinate license applications and renewals (Professional, DEA, etc.).
• Collaborate with practice to obtain credentialing data for privileging.
• Handle revalidation requests from government payers.
• Complete credentialing and re-credentialing applications for payers.
• Credential new providers and those with facilities staff privileges.
• Work with CBO and billing teams to resolve denials and authorization issues.
• Maintain provider profiles on CAQH, PECOS, NPPES, CMS; review rosters with payers.

Conocimientos

Attention to detail

Communication

Customer service

Self-motivation

Educación

High school diploma or GED

Undergraduate degree or equivalent experience

Herramientas

Excel

Word

Cloud/Internet tools

Descripción del empleo

SCA Health in the United States is hiring a Credentialing Specialist to manage the end-to-end provider credentialing with insurers, Medicare and Medicaid. You will maintain provider files, update CAQH records, coordinate licenses, and collaborate with practice and billing to resolve credentialing issues.

The role requires strong attention to detail, excellent communication, and extensive experience in medical office credentialing and privileging processes, with a focus on timely, accurate