Payor Credentialing Specialist

Mount Carmel Health System; Columbus (OH); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

DailyPay

Relocation assistance

Tuition/professional development reimb

Employee referral rewards

Diversity, Equity & Inclusion groups

Tuition reimbursement

Annual leave / PTO benefits

Job summary

Mount Carmel Health System is seeking a Credentialing Specialist to oversee the efficient administration of credentialing and re-credentialing for its large multi-specialty medical group and hospital facilities. You will coordinate applications, renewals, and enrollment with multiple third-party payers, and maintain databases serving credentialing and billing teams.

Key duties include facilitating facility privileging, supporting malpractice applications, and acting as a liaison to providers and

Qualifications

• Must possess an associate degree in a related field.
• 3-5 years of professional office experience.
• 2 years of medical billing experience with Medicare/Medicaid, HMO and Commercial plans.
• Experience with third-party payor credentialing, enrollment, or facility privileging preferred.

Responsibilities

• Coordinate credentialing and re-credentialing for large multi-specialty groups and multiple hospital facilities.
• Coordinate applications and renewals for insurance credentialing and enrollment across multiple payers.
• Maintain databases to support credentialing and enrollment; liaison with providers, operations, revenue-site operations and billing.

Skills

Credentialing

Medical billing

Payer liaison

Office administration

Education

Associate degree in related field

Tools

Credentialing databases

Job description

Employment Type: Full time Shift:

Position Purpose:

• Responsible for the efficient administration of credentialing/re-credentialing for large multi-specialty medical group and multiple hospital facilities. Coordinates the application and renewal of insurance credentialing and enrollment for multiple third-party payers. Maintains a variety of databases to support the credentialing and enrollment functions; acts as a liaison for providers, operations, revenue site operations, and professional billing for credentialing and enrollment processes. Provides dedicated support to the professional coding and billing teams.

What You Will Do:

• Coordinates the facility privileging and re-privileging processes for Medical Group Providers, including but not limited to: facilitates information collection, completes application forms, coordinates submission of applications, and supports necessary follow-up, problem investigation and resolution.
• Facilitates malpractice application and renewal processes for all employed providers, including annual updates to payers and healthcare facilities.

Minimum Qualifications:

• Education: Must possess a comprehensive knowledge in practice and medical management, as normally obtained through an associate degree in a related field, and 3-5 years of professional office experience, including 2 years of medical billing experience with an understanding of Medicare, Medicaid, Health Maintenance Organization and Commercial insurance plans.
• Experience: Prior experience with third-party payor credentialing, enrollment, or facility privileging preferred.

Position Highlights and Benefits:

• Mount Carmel Health System recognized by Forbes in 2025 as one of America’s Best State Employers.
• Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
• Retirement savings account with employer match starting on day one.
• Generous paid time off programs.
• Employee recognition programs.
• Tuition/professional development reimbursement starting on day one.
• RN to BSN tuition 100% paid at Mount Carmel’s College of Nursing.
• Relocation assistance (geographic and position restrictions apply).
• Employee Referral Rewards program.
• Mount Carmel offers DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday. You deserve to get paid every day!
• Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Ministry/Facility Information:

Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio’s largest undergraduate, graduate, and doctor of nursing programs. If you’re seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!

Our Commitment:

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.