Remote Credentialing Specialist - Healthcare Enrollment

Aegis Health; Mesa (AZ); Remote; USD 60,000 - 70,000; Full time

Benefits offered by this job

Career Longevity

Professional Development

Meaningful Work

Employee Experience

Comprehensive Benefits Package

Job summary

Atlas Medical in Arizona (Remote) is seeking a detail-oriented Credentialing Specialist to manage provider credentialing, recredentialing, and enrollment processes. You will ensure regulatory compliance and timely enrollment with insurance networks while maintaining accurate provider records.

The ideal candidate has 5+ years of healthcare credentialing, CPCS or CPMSM certification, and proficiency with CAQH/NPPES/PECOS.

Qualifications

• 5+ years of healthcare credentialing experience.
• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM).
• Knowledge of Medicare, Medicaid, and commercial payer enrollment processes.
• Familiarity with CAQH, NPPES, PECOS, and provider enrollment systems.
• Strong understanding of healthcare compliance and credentialing standards.

Responsibilities

• Coordinate and manage provider credentialing and recredentialing activities.
• Prepare, submit, and track credentialing applications with Medicare, Medicaid, commercial payers, and regulatory agencies.
• Maintain accurate provider files, including licenses, certifications, malpractice insurance, and continuing education documentation.
• Monitor credential expiration dates and ensure timely renewals.
• Facilitate provider enrollment, updates, and terminations with insurance carriers.
• Respond to payer inquiries and resolve credentialing related issues.
• Maintain compliance with healthcare regulations, accreditation standards, and organizational policies.
• Generate credentialing reports and maintain confidential provider records.
• Assist with audits and support practice operations as needed.

Skills

Healthcare credentialing

CPCS/CPMSM

Medicare/Medicaid enrollment

CAQH/NPPES/PECOS

MS Office proficiency

Education

High school diploma

Associate or bachelor's degree preferred

Tools

Credentialing software systems

Job description

Atlas Medical in Arizona (Remote) is seeking a detail-oriented Credentialing Specialist to manage provider credentialing, recredentialing, and enrollment processes. You will ensure regulatory compliance and timely enrollment with insurance networks while maintaining accurate provider records.

The ideal candidate has 5+ years of healthcare credentialing, CPCS or CPMSM certification, and proficiency with CAQH/NPPES/PECOS.