Remote Medical Credentialing Specialist

Claim.MD; Pecos (NM); On-site; USD 76,000 - 86,000; Full time

Benefits offered by this job

Internet Reimbursement - Up to $100/mo

Comprehensive Benefits Package

Paid Time Off and holidays

Job summary

Claim.MD, a national healthcare credentialing leader, seeks a Medical Credentialing Specialist to manage research, documentation, and operations across commercial, government, and managed care payers. The role blends regulatory experience with process improvement in a fully remote setting.

You will monitor CMS and payer changes, maintain comprehensive credentialing resources, and collaborate with internal teams to ensure audit-ready documentation and compliant enrollment practices.

Qualifications

• Thorough understanding of provider credentialing, enrollment, and revalidation.
• Knowledge of CMS regulations and payer enrollment standards.
• Ability to interpret complex payer requirements into resources.
• Experience with CAQH ProView and payer portals.
• Strong documentation and knowledge management skills.
• Remote/work-from-home capability.

Responsibilities

• Credentialing research and knowledge management.
• Maintain payer-specific credentialing documentation.
• Monitor regulatory changes affecting credentialing.
• Standardize operational materials and workflows.
• Collaborate with cross-functional teams.
• Provide SME guidance on credentialing standards.

Skills

Credentialing

Payer enrollment

CMS knowledge

Research & analysis

Documentation

Compliance

Communication

Remote work

Education

High school diploma or GED

Bachelor’s degree in Healthcare Administration (preferred)

Tools

CAQH ProView

PECOS

NPPES

Medicaid portals

Job description

Claim.MD, a national healthcare credentialing leader, seeks a Medical Credentialing Specialist to manage research, documentation, and operations across commercial, government, and managed care payers. The role blends regulatory experience with process improvement in a fully remote setting.

You will monitor CMS and payer changes, maintain comprehensive credentialing resources, and collaborate with internal teams to ensure audit-ready documentation and compliant enrollment practices.