Credentialing Specialist
About The Position
At Atlas Medical we're expanding our team and are seeking a dynamic and compassionate Credentialing Specialist who shares our passion for making healthcare better for all. If you're someone who values meaningful work, thrives in a supportive environment, and believes in enriching the lives of those you encounter, this may be the perfect opportunity for you. We are seeking a detail-oriented Healthcare Credentialing Specialist to manage provider credentialing, recredentialing, and enrollment processes. The ideal candidate will ensure healthcare providers maintain compliance with regulatory requirements and payer standards while supporting timely enrollment with insurance networks.
Requirements
- High school diploma or equivalent required; associate or bachelor's degree preferred.
- 5+ years of healthcare credentialing experience.
- Must have Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM)
- Knowledge of Medicare, Medicaid, and commercial payer enrollment processes.
- Familiarity with CAQH, NPPES, PECOS, and provider enrollment systems.
- Strong understanding of healthcare compliance and credentialing standards.
- Excellent organizational, communication, and problem-solving skills.
- Proficiency in Microsoft Office and credentialing software systems.
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
Responsibilities
- Coordinate and manage provider credentialing and recredentialing activities.
- Prepare, submit, and track credentialing applications with Medicare, Medicaid, commercial payers, and regulatory agencies.
- Maintain accurate provider files, including licenses, certifications, malpractice insurance, and continuing education documentation.
- Monitor credential expiration dates and ensure timely renewals.
- Facilitate provider enrollment, updates, and terminations with insurance carriers.
- Respond to payer inquiries and resolve credentialing related issues.
- Maintain compliance with healthcare regulations, accreditation standards, and organizational policies.
- Generate credentialing reports and maintain confidential provider records.
- Assist with audits and support practice operations as needed.
Benefits
- 22 days of PTO
- Medical, Dental, and Vision insurance options
- 401(k) with employer matching
- Life, Accident, and Disability Insurance
- Referral bonuses
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
