Payor Credentialing Specialist – Revenue Cycle Impact

Cabinet Peaks Medical Center; Libby (MT); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Full benefits package

Job summary

Cabinet Peaks Medical Center seeks a Payor Credentialist to join the Revenue Cycle Team. The role coordinates provider enrollment with Medicare, Medicaid, and commercial payers and maintains up-to-date credentialing data.

Responsibilities include managing CAQH ProView/PECOS/NPPES profiles, credential verification, and collaboration with billing to resolve denials and ensure seamless revenue cycle operations.

Qualifications

• Experience in medical billing, provider enrollment, or healthcare administration preferred.
• CPCS credentials preferred.
• High attention to detail and strong organizational skills are essential.

Responsibilities

• Prepare, submit, and track credentialing applications for Medicare, Medicaid, and commercial plans.
• Maintain provider profiles on CAQH ProView, PECOS, and NPPES.
• Authenticate credentials including licenses, DEA certificates, and malpractice coverage.
• Monitor expiration dates to avoid gaps in network participation.
• Follow up with payers to resolve delays or denials in credentialing.

Skills

Verbal and written communication

Attention to detail

Independent work

Team collaboration

Medical terminology knowledge

Education

High school diploma or equivalent

CPCS credentials (preferred)

Tools

Meditech knowledge

Job description

Cabinet Peaks Medical Center seeks a Payor Credentialist to join the Revenue Cycle Team. The role coordinates provider enrollment with Medicare, Medicaid, and commercial payers and maintains up-to-date credentialing data.

Responsibilities include managing CAQH ProView/PECOS/NPPES profiles, credential verification, and collaboration with billing to resolve denials and ensure seamless revenue cycle operations.