Medical Credentialing Specialist — Payer Enrollment Pro

Valid8 Financial, Inc.; New York (NY); On-site; USD 46,000 - 60,000; Full time

Job summary

New Horizon Billing Solutions (NHBS) in Las Vegas, NV is seeking a Medical Credentialing Specialist to manage credentialing, re-credentialing, and payer enrollment for healthcare providers.

You will verify licenses and certifications, maintain provider data in CAQH, NPPES, and PECOS, and handle provider communications to ensure uninterrupted billing. This is a full-time on-site role with a competitive compensation package.

Qualifications

• High school diploma or GED required.
• 2+ years credentialing or payer enrollment experience in healthcare.
• Hands-on familiarity with CAQH, NPPES, PECOS, and payer enrollment.
• Proficiency in Microsoft Office and credentialing software.

Responsibilities

• Process initial credentialing and re-credentialing applications for physicians, APs, and other licensed professionals.
• Perform primary source verification of education, licensure, board certification, work history, and other credentials.
• Maintain up-to-date provider files and profiles per regulations.
• Submit credentialing/enrollment packets to Medicare, Medicaid, and commercial payers; follow up for approval.
• Maintain provider records in CAQH, NPPES, and PECOS; manage attestations.

Skills

Attention to detail

Organizational skills

Communication

Time management

Discretion/Confidentiality

Education

High school diploma or GED

Tools

CAQH

NPPES

PECOS

MedTrainer

Job description

New Horizon Billing Solutions (NHBS) in Las Vegas, NV is seeking a Medical Credentialing Specialist to manage credentialing, re-credentialing, and payer enrollment for healthcare providers.

You will verify licenses and certifications, maintain provider data in CAQH, NPPES, and PECOS, and handle provider communications to ensure uninterrupted billing. This is a full-time on-site role with a competitive compensation package.