Healthcare Insurance Credentialing Specialist

We are seeking a detail-oriented Medical Insurance Credentialing Specialist to manage provider enrollment and credentialing with US health insurance companies. The ideal candidate will have experience navigating US healthcare insurance systems and coordinating credentialing applications for physicians and medical practices.

Key Responsibilities

Complete and manage provider enrollment applications with commercial insurance companies, Medicare, and Medicaid.

Maintain and update CAQH profiles, NPI records, PECOS, and other credentialing databases.

Coordinate with insurance companies to track applications, resolve issues, and obtain approvals.

Manage provider recredentialing, renewals, and ongoing compliance requirements.

Maintain accurate records of credentialing status, payer contracts, and effective dates.

Assist with insurance network participation and payer contracting processes.

Qualifications

Prior experience in US medical insurance credentialing or provider enrollment strongly preferred.

Familiarity with CAQH, PECOS, Medicare, Medicaid, and major US commercial insurance companies.

Excellent written and spoken English.

Strong organizational skills, attention to detail, and ability to work independently.

Comfortable communicating with US insurance companies via phone and email.

Experience with US medical billing or revenue cycle management is a plus.

Preferred Candidate: Someone with 1–3+ years of experience working for a US healthcare practice, medical billing company, or credentialing agency.

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