Payer Credentialing Specialist

Merakey • Whitemarsh Township, PA

5h • Remote

About The Position

The Payer Credentialing Specialist is responsible for managing all aspects of staff payer credentialing across Merakey. This role serves as the primary point of contact for facility and practitioner credentialing and re-credentialing processes, ensuring compliance with payer requirements and organizational standards. The position reports directly to the Contracting and Credentialing Supervisor. Merakey is a non-profit provider of developmental, behavioral health, and education services, with over 8,000 employees supporting nearly 40,000 individuals and families across 12 states.

Requirements

• Associate Degree or two years equivalent work experience required
• Minimum of two years of credentialing experience including work with CAQH and provider enrollment processes
• Strong knowledge of credentialing processes, including payer submissions, re-credentialing, and maintaining Medicare/Medicaid enrollments
• Strong computer proficiency, including Microsoft Excel, Word, and Outlook, along with solid organizational and time management skills
• Excellent written and verbal communication skills, with the ability to communicate effectively with internal and external stakeholder
• Experience maintaining provider data across CAQH, PECOS, PROMISe, and other payer systems, ensuring accuracy and compliance

Nice To Haves

• Bachelor’s Degree preferred
• Experience with MD-Staff credentialing system

Responsibilities

• Ensure timely and accurate submission of initial and re-credentialing applications for all employed and contracted providers
• Maintain active Medicare and Medicaid enrollments for all eligible providers
• Manage and update provider records across CAQH, PECOS, PROMISe, and other payer systems, ensuring accuracy and compliance
• Track and maintain all required documentation (e.g., licenses, DEA, malpractice insurance) to ensure records remain current
• Respond promptly to payer requests for additional or missing information to support credentialing processes
• Provide regular status updates on credentialing progress for new and existing providers
• Research and resolve credentialing-related claim issues, collaborating with operations and business teams
• Build and maintain strong working relationships with providers, program leadership, and support teams
• Adhere to all organizational policies, procedures, and standards
• Perform other duties as assigned

Benefits

• Comprehensive medical, dental, and vision coverage, plus access to healthcare advocacy support.
• Retirement plan -- both pre-tax and Roth (after-tax) options available for employee contributions.
• DailyPay -- access your pay when you need it!
• On the Goga well-being platform, featuring self-care tools and resources.
• Access Care.com for backup childcare, elder care, and household services.
• Confidential counseling, legal, and financial services through our Employee Assistance Program (EAP).
• Tuition reimbursement and educational partnerships.
• Employee discounts and savings programs on entertainment, travel, and lifestyle.
• Access to Pryor Online Learning for free online personal development classes.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 501-1,000 employees