Payer Credentialing Specialist

MerakeyWhitemarsh Township, PA
Remote

About The Position

Merakey is seeking a Payer Credentialing Specialist to join their team. This remote position is responsible for managing all aspects of staff payer credentialing across Merakey, serving as the primary point of contact for facility and practitioner credentialing and re-credentialing processes. The role ensures compliance with payer requirements and organizational standards. The position reports directly to the Contracting and Credentialing Supervisor.

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

Nice To Haves

  • Bachelor’s Degree preferred
  • Experience with MD-Staff credentialing system
  • Experience maintaining provider data across CAQH, PECOS, PROMISe, and other payer systems, ensuring accuracy and compliance

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.
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