Credentialing Specialist

erform end-to-end credentialing and re-credentialing for healthcare providers with US insurance payers Handle payer enrollments (Medicare, Medicaid, and commercial plans) to ensure billing readiness Maintain and regularly update CAQH profiles, ensuring accuracy for claim processing Verify provider eligibility before onboarding to avoid claim rejections/denials Coordinate closely with medical billing teams to resolve credentialing-related claim issues Monitor and follow up on pending applications to prevent revenue delays Ensure all provider data (NPI, taxonomy, licenses, malpractice insurance) is accurate and up to date Work on ERA/EFT enrollments to streamline payment processes Support denial management by identifying credentialing gaps impacting reimbursements Maintain compliance with payer-specific guidelines and regulatory requirements Prepare credentialing status reports, turnaround time tracking, and aging reports Job Type: Full-time Work Location: In person