Healthcare Credentialing Specialist — Flexible Schedule

Dean Dorton; Raleigh (NC); Hybrid; USD 52,000 - 70,000; Full time

Benefits offered by this job

Flexible work schedules

Paid Time Off

Paid family leave, medical leave, and育

Retirement benefits

Telemedicine and wellness support

Job summary

Dean Dorton is seeking a Credentialing Services Specialist to ensure healthcare providers are accurately credentialed and enrolled with payers, enabling timely reimbursements and uninterrupted patient care.

The role manages applications, licensure tracking, and ongoing compliance across states and payer types, requiring meticulous attention to detail and confidentiality. This position suits someone who thrives in a fast-paced environment and values precise credentialing processes.

Qualifications

• Minimum of 2 years of provider credentialing experience.
• Experience across multiple payers and specialties preferred.
• Familiarity with Intellisoft and CAQH databases.
• Strong attention to detail and organizational skills.
• Ability to manage multiple priorities with deadlines.
• Commitment to confidentiality and HIPAA compliance.

Responsibilities

• Manage provider credentialing and enrollment with Medicare, Medicaid, and commercial payers.
• Initiate payer contracts for new physician practices and monitor revalidations and renewals.
• Maintain accurate provider records including licensure, certifications, malpractice insurance, and DEA registration.
• Complete applications in Intellisoft, CAQH, and payer-specific portals.
• Track and resolve credentialing-related issues to ensure uninterrupted claim processing and payment.
• Research credentialing requirements and payer policy changes, sharing updates with clients and team members.
• Ensure compliance with all federal, state, and payer-specific credentialing regulations.

Skills

Attention to detail

Communication skills

Customer service

HIPAA compliance

Tools

Intellisoft

CAQH

Microsoft Office

Payer portals/EFT systems

Job description

Dean Dorton is seeking a Credentialing Services Specialist to ensure healthcare providers are accurately credentialed and enrolled with payers, enabling timely reimbursements and uninterrupted patient care.

The role manages applications, licensure tracking, and ongoing compliance across states and payer types, requiring meticulous attention to detail and confidentiality. This position suits someone who thrives in a fast-paced environment and values precise credentialing processes.