Insurance Credentialing Specialist

This is a remote position.

We are looking for an experienced Credentialing Specialist to manage provider credentialing and payer enrollment from start to finish. This role will own the full credentialing lifecycle, from initial enrollment and contracting through recredentialing, revalidation, and ongoing maintenance—across multiple payers and states.

The ideal candidate is highly organized, detail-oriented, and persistent with payer follow-ups. You will be responsible for making sure applications move forward without unnecessary delays and that providers remain active and in-network with no lapses in credentialing.

Key Responsibilities

Manage the full credentialing lifecycle, including initial payer enrollment, contracting, recredentialing, revalidation, and ongoing payer participation across multiple payers and states.

Prepare, submit, and track applications from initial submission through approval and confirmed effective date.

Build and maintain CAQH ProView profiles, including initial setup, attestations, and reattestations.

Ensure provider information is accurate and consistent across CAQH, payer portals, and internal records.

Maintain complete and current provider files, including:

NPI Type 1 and Type 2

Taxonomy codes

State licenses

DEA registrations

Board certifications

Malpractice insurance

Provider demographics and practice information

Submit and manage Medicare enrollment through PECOS.

Complete enrollment with state Medicaid programs and managed-care plans, as well as commercial and behavioral health payers.

Monitor pending, incomplete, returned, and rejected applications and follow up proactively through payer portals and provider-enrollment phone lines.

Resolve enrollment issues and follow applications through to an approved effective date.

Maintain a centralized credentialing tracker and provide weekly status reports.

Monitor upcoming recredentialing, revalidation, license, certification, and other expiration deadlines to prevent lapses.

Escalate payer delays or issues when necessary.

Coordinate with billing to confirm payer enrollment and effective dates so claims are not submitted before a provider is properly active.

Maintain accurate, organized, and audit-ready credentialing documentation.

Requirements

Required Knowledge & Systems Experience

Candidates should have hands-on experience with:

CAQH ProView

NPPES / NPI Registry

PECOS for Medicare enrollment

State Medicaid provider portals

Commercial payer portals, including Availity and payer-specific systems

Provider credentialing and payer enrollment processes

Taxonomy codes and provider enrollment documentation

Payer-specific enrollment and credentialing requirements

What We're Looking For

Proven experience in provider credentialing and payer enrollment

Strong understanding of Medicare, Medicaid, commercial, and behavioral health payer enrollment

Excellent attention to detail and documentation management

Strong follow-up skills and persistence when working with payers

Ability to manage multiple providers, payers, states, and deadlines simultaneously

Strong organizational and time-management skills

Ability to identify missing or inconsistent information before it causes enrollment delays

Comfortable communicating with payer representatives and provider enrollment departments

Self-directed and able to manage the credentialing process with minimal supervision

Success in This Role

You’ll be successful in this role if you can keep credentialing moving, minimize avoidable enrollment delays, maintain accurate provider records, and ensure providers are approved and active with the appropriate payers without credentialing lapses.

Benefits

Compensation & Payments

Competitive hourly rate

On-time payments, every time

Payments processed via Wise

Training & Support

Direct client training provided — you are never thrown in blind

Dedicated Account Manager as your point of contact

Stable, long-term placement with a growing U.S.-based company

Exposure to a wide range of modern SaaS platforms

Potential for increased responsibilities as the company scales

Tenure recognition for long-term team members

Clear escalation paths — you always know who to go to

Work Environment

100% remote — work from home

U.S.-based company with structured operations

Stable, long-term account placements (not gig-style work)

Supportive team culture across all accounts

Growth & Experience

Build your U.S. industry experience

Exposure to multiple practice types and platforms

Potential for increased hours or additional accounts based on performance

Strengthen your resume with verified, legitimate U.S. client experience

Recognition

Tenure recognition for long-term team members

We value loyalty and recognize those who grow with us