Remote Credentialing & Reimbursement Specialist

Aliviane; El Paso (TX); Hybrid; USD 23,000 - 25,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k)

Paid time off

Extended illness leave

Paid holidays

Mental health hours

Career growth

Flexible schedule

Half day Friday

Life insurance

Short-term disability

Job summary

Aliviane Inc. is seeking a Credentialing / Reimbursement Specialist to manage credentialing and contracting requests from a remote/office-based setting in El Paso, TX.

The role collaborates with billing to ensure timely processing and accurate reporting of credentials for providers and facilities. Ideal candidates will have a CPCS or similar credentialing certification, plus 5 years of relevant experience, and a strong understanding of payer requirements and systems like PEMS/CAQH/CMS.

Qualifications

• Associate degree or technical school completion.
• At least 5 years of similar work experience.
• CPCS or similar certification preferred.
• Experience in Behavioral Health preferred.
• Excellent verbal and communication skills.
• Attention to detail in documentation and deadlines.
• Knowledge of payer requirements for provider types.
• Familiarity with PEMS, CAQH and CMS.

Responsibilities

• Submit, track, and respond to credentialing and contracting requests.
• Assist billing department with assigned tasks.
• Monitor licensure and credentialing for facilities and providers.
• Follow up on all applications and provide up-to-date reports.
• Work independently, set priorities, and meet deadlines.
• Support with billing projects.
• Collaborate with management on licensure planning.
• Gather information from new providers to complete credentialing.

Skills

Verbal communication

Attention to detail

Payer requirements knowledge

PEMS/CAQH/CMS knowledge

Education

Associate degree or technical school

CPCS certification preferred

Behavioral Health experience preferred

Tools

PEMS

CAQH

CMS

Job description

Aliviane Inc. is seeking a Credentialing / Reimbursement Specialist to manage credentialing and contracting requests from a remote/office-based setting in El Paso, TX.

The role collaborates with billing to ensure timely processing and accurate reporting of credentials for providers and facilities. Ideal candidates will have a CPCS or similar credentialing certification, plus 5 years of relevant experience, and a strong understanding of payer requirements and systems like PEMS/CAQH/CMS.