Insurance Credentialing Specialist

remote work; United States; Remote; USD 60,000 - 75,000; Full time

Job summary

HelpSquad is seeking an experienced Credentialing Specialist to manage provider credentialing and payer enrollment from start to finish. This role owns the full credentialing lifecycle across multiple payers and states, ensuring providers remain active and in-network with no lapses in credentialing.

The ideal candidate will have hands-on experience with CAQH ProView, NPPES/NPI Registry, PECOS, and Medicaid/Commercial payer portals, along with a strong understanding of Medicare and Medicaid

Qualifications

• Hands-on experience with CAQH ProView, NPPES/NPI Registry, PECOS, and Medicaid/Commercial payer portals.
• Strong knowledge of Medicare, Medicaid, commercial, and behavioral health payer enrollment.
• Excellent attention to detail and documentation management.

Responsibilities

• Manage initial enrollment, contracting, recredentialing, and ongoing payer participation across multiple payers and states.
• Prepare, submit, and track applications through approval and effective dates.
• Build and maintain CAQH ProView profiles and attestations.
• Maintain accurate provider records in CAQH, payer portals, and internal systems.
• Submit and manage Medicare enrollment through PECOS and enroll with state Medicaid and other payers.
• Monitor and follow up on pending or rejected applications and elevate delays as needed.

Skills

Attention to detail

Follow-up skills

Multitasking

Self-direction

Communication

Tools

CAQH ProView

PECOS

NPPES/NPI Registry

Payer portals

Job description

About the role

HelpSquad is hiring an experienced Credentialing Specialist to manage provider credentialing and payer enrollment from start to finish. This role owns the full credentialing lifecycle across multiple payers and states, ensuring providers remain active and in-network with no lapses in credentialing.

What you'll do

• Manage initial enrollment, contracting, recredentialing, and ongoing payer participation across multiple payers and states
• Prepare, submit, and track applications through approval and effective dates
• Build and maintain CAQH ProView profiles and attestations
• Maintain accurate provider records in CAQH, payer portals, and internal systems
• Submit and manage Medicare enrollment through PECOS and enroll with state Medicaid and other payers
• Monitor and follow up on pending or rejected applications and elevate delays as needed

What they're looking for

• Hands-on experience with CAQH ProView, NPPES/NPI Registry, PECOS, and Medicaid/Commercial payer portals
• Strong knowledge of Medicare, Medicaid, commercial, and behavioral health payer enrollment
• Excellent attention to detail and documentation management
• Strong follow-up skills and persistence when dealing with payers
• Ability to manage multiple providers, payers, states, and deadlines simultaneously
• Self-directed with minimal supervision and effective communication with payer representatives

For applicants in Nigeria

• The listing states 100% remote and a U S based company; it does not specify Nigeria-specific hiring eligibility. Confirm before interviewing.
• Timezone expectations are not stated in the listing. Confirm during interviews.
• It does not specify contractor vs employee terms. Confirm during interview process.