Remote Credentialing Specialist: In-Network Enrollment Pro

CredSpun LLC; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

CredSpun LLC is seeking a Remote Credentialing Specialist to manage provider enrollment across CAQH, PECOS, Medicaid and commercial panels, ensuring timely and accurate submissions.

You will collect documents, build CAQH ProView profiles, track applications, and coordinate with payers to secure effective dates and active in-network status.

This role requires two+ years of credentialing experience, strong organization, and professional communication with payer relations teams.

Qualifications

• Two or more years of provider credentialing or payer enrollment experience.
• Hands-on CAQH ProView, NPPES and payer portal experience.
• Familiarity with Medicare enrollment (PECOS, CMS-855I/855B/855R) and state Medicaid enrollment.
• Strong organisation and ability to manage multiple applications.
• Professional telephone manner when contacting payer relations teams.

Responsibilities

• Collect and verify provider documents: licences, DEA, board certification, malpractice, CV, W-9
• Build, audit and re-attest CAQH ProView profiles and grant payer access
• Prepare and submit commercial, Medicare and Medicaid applications and track each by payer
• Follow up with payers on a set schedule and log reference numbers, contacts and outcomes
• Confirm effective dates and loaded contracts before the first claim to each payer is sent
• Track expirables and run re-credentialing and revalidation ahead of deadlines
• Keep a clear status report for each provider that the practice can read at a glance
• Hand enrollment status to the billing team so claims are held or released correctly

Skills

CAQH ProView

NPPES

Payer portal

Organization

Persistence

Tools

CAQH ProView

NPPES

CMS portals

Job description

CredSpun LLC is seeking a Remote Credentialing Specialist to manage provider enrollment across CAQH, PECOS, Medicaid and commercial panels, ensuring timely and accurate submissions.

You will collect documents, build CAQH ProView profiles, track applications, and coordinate with payers to secure effective dates and active in-network status.

This role requires two+ years of credentialing experience, strong organization, and professional communication with payer relations teams.