Credentialing/Payor Specialist

Capitol Imaging Services

. Develop and execute strategies to reduce insurance denials and payer write-offs .

Posted 10/3/2026full-timeRemote • Louisiana • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in healthcare credentialing and reimbursement processes, with a strong focus on reducing insurance denials and managing provider enrollments. Proficient in maintaining compliance and documentation while effectively communicating with internal teams and payers.

Highest-signal resume keywords

Healthcare CredentialingProvider EnrollmentDenial ManagementMedicare And Medicaid ProcessesMicrosoft Office Proficiency

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Insurance Denial ReductionClaims ProcessingOperational SOP DevelopmentAccounts Receivable TrackingCredentialing Application SubmissionPayment Discrepancy ResolutionDocumentation TrackingFee Schedule MaintenanceHIPAA ComplianceRemote Work Management

Soft Skills

Excellent Communication SkillsDetail-OrientedDeadline-DrivenSelf-MotivatedProfessionalism

Tools & Technologies

CAQHPECOSNPPESWeb-Based SystemsElectronic Credentialing Files

Industry Keywords

HealthcareReimbursementRadiologyDiagnosticsInsurance Enrollment

About the role

Key responsibilities & impact

Develop and execute strategies to reduce insurance denials and payer write-offs
Identify, analyze, and prioritize denial and non-payment root causes across modalities, payers, and sites
Design and implement systematic solutions to prevent recurring denials
Identify denial trends and convert them into operational SOPs
Follow up with payers to resolve claim denials and payment discrepancies
Investigate payment and reimbursement delays and support accurate claims processing
Monitor and track outstanding accounts receivable
Collect, verify, maintain, and update facility and provider credentials
Prepare and submit initial and re-credentialing applications
Maintain electronic credentialing files and track credential expirations and renewals
Submit provider enrollment applications for Medicare, Medicaid, and commercial payors
Manage enrollments through CAQH, PECOS, NPPES, and payor-specific portals
Follow up with payors regarding delays, missing documentation, and application deficiencies
Confirm provider participation status and effective dates
Maintain up-to-date fee schedules
Update payors on provider demographics, locations, group affiliations, and tax information
Maintain compliance documentation for audits and internal reviews
Partner with billing, revenue cycle, and leadership teams to resolve credentialing- and enrollment-related claim issues
Communicate with internal teams via email, phone, and virtual meetings
Manage workload independently while meeting deadlines and productivity expectations

Requirements

What you’ll need

Expertise in healthcare credentialing/reimbursement, preferably radiology or diagnostics
5+ years of experience in provider credentialing, payor enrollment, and denial management
Strong knowledge of Medicare, Medicaid, and commercial insurance enrollment processes
Proven success reducing denials and write-offs
Ability to manage multiple providers and deadlines independently in a remote setting
Excellent written and verbal communication skills
Highly detail-oriented and deadline-driven
Comfortable with frequent follow-ups and documentation tracking, particularly in AR
Proficient with Microsoft Office and web-based systems
Self-motivated and able to work independently in a remote environment
Maintains confidentiality and professionalism
Reliable internet access
Ability to maintain a secure, HIPAA-compliant remote work environment

Benefits

Comp & perks

Fully remote work arrangement
Secure, HIPAA-compliant remote work environment
Flexible independent workload management