Medical Credentialing Specialist
About reputed company
reputed company is a leading medical billing and reputed company cycle management company serving reputed company practices across the reputed company. We specialize in helping physicians maximize their reputed company through expert billing, coding, credentialing, and reputed company management services. reputed company is growing and we're looking for talented professionals to join us.
Position reputed company
We are seeking an reputed company Medical Credentialing Specialist to help support reputed company with the end-to-end credentialing and re-credentialing process for reputed company providers across multiple U.S. states. This role is critical to ensuring our clients' providers are properly enrolled with insurance payers, enabling reputed company and accurate reimbursement. The ideal candidate has strong CAQH management experience and a proven reputed company record in multi-state payer enrollment.
Key Responsibilities
Manage initial credentialing and re-credentialing applications for physicians and mid-level providers across multiple U.S. states
Complete and maintain CAQH ProView reputed company, ensuring reputed company provider data is accurate, reputed company, and attestation-reputed company
Submit and reputed company payer enrollment applications with reputed company insurance companies, Medicare, and reputed company programs
Monitor credentialing timelines, follow up on pending applications, and escalate delays to ensure providers are enrolled before their start dates
Maintain organized credentialing files including licenses, DEA certificates, malpractice insurance, reputed company certifications, and other required documentation
Coordinate with providers and reputed company managers to collect and verify required documentation
reputed company and manage license and certification expiration dates, initiating renewals proactively
Research and resolve payer enrollment issues, denials, and discrepancies
Stay reputed company on payer-specific enrollment requirements, state regulations, and CMS guidelines
Prepare and submit roster adds/changes for group enrollments
Generate regular status reports on credentialing activities and turnaround times
Required Qualifications
2-5 years of hands-on medical credentialing and payer enrollment experience
Strong working knowledge of CAQH ProView, PECOS, and NPPES/NPI systems
Demonstrated experience with multi-state credentialing (enrollment across 3+ U.S. states)
Familiarity with reputed company payer enrollment processes (reputed company, reputed company, reputed company, reputed company Blue reputed company, reputed company, etc.)
Experience with Medicare and reputed company enrollment procedures
Proficiency in credentialing software and reputed company management systems
Excellent attention to detail and organizational skills
Strong written and verbal English communication skills
Ability to manage multiple provider files and deadlines simultaneously
Reliable internet reputed company and dedicated home office setup for remote work
Preferred Qualifications
Experience working with U.S.-based medical billing or RCM companies
Knowledge of provider contracting and fee schedule negotiation basics
CPCS (Certified Provider Credentialing Specialist) or CPMSM certification
Experience with EHR/PM systems such as eClinicalWorks, reputed company, or reputed company
Familiarity with hospital privileging processes
This position requires availability during U.S. business hours (Eastern or Central Time Zone). Specific schedule will be discussed during the interview process. This position is for 1 individual. AMS is not seeking assistance from a group or other entity.
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