Remote Credentialing Specialist: Enrollments & Payer

Remote Jobs; Town of Oconomowoc (WI); Hybrid; USD 52,000 - 72,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

401(k) retirement plan

Employee share program

Life/disability insurance

Flex spending accounts

Tuition reimbursement

Health and wellness program

Employee assistance program (EAP)

Job summary

Rogers Memorial Hospital, Inc. seeks a Credentialing Specialist to manage facility and practitioner enrollment, CAQH data, and provider credentialing across payer networks. You will liaise with payer strategies, medical staff, and finance to ensure accurate network status and timely enrollment.

The role supports both on-site and remote work, requiring knowledge of HIPAA and credentialing standards. A degree or equivalent experience is required with NA)

Qualifications

• Associate's degree or 2 years' experience.
• Administrative skills, including computer/word processing.
• Proficiency with Microsoft Office, Adobe and Excel.
• Exceptional critical thinking and sound judgement.
• Excellent written, verbal, and auditory communication.
• Ability to perform all essential job functions on site or remotely.

Responsibilities

• Maintain understanding of privacy, HIPAA, Medical Staff standards and policies.
• Handle facility and practitioner enrollment across multiple systems.
• Maintain knowledge of data locations and standard work for credentialing.
• Populate CAQH and provider information in systems.
• Communicate provider status and renewal updates to teams.
• Back-up other Payer Strategies roles as needed.
• Support process improvements and payer communications.

Skills

Administrative skills

Microsoft Office

Adobe

Excel

Critical thinking

Written communication

Verbal communication

Education

Associate's degree

NAMSS/CPCS Certification

Tools

Symplr

CAQH

Job description

Rogers Memorial Hospital, Inc. seeks a Credentialing Specialist to manage facility and practitioner enrollment, CAQH data, and provider credentialing across payer networks. You will liaise with payer strategies, medical staff, and finance to ensure accurate network status and timely enrollment.

The role supports both on-site and remote work, requiring knowledge of HIPAA and credentialing standards. A degree or equivalent experience is required with NA)