Credentialing Specialist

CIVIE

. Manage the full credentialing and re-credentialing process for assigned providers .

Posted 11/9/2026full-timeRemote • United StatesJuniorMid-Level💰 $45,000 - $55,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing the credentialing and re-credentialing processes, ensuring compliance with state and federal standards while maintaining accurate provider records. Proficient in utilizing credentialing databases and electronic systems to enhance efficiency and accuracy.

Highest-signal resume keywords

Credentialing ExperienceCAQH ProficiencyAttention To DetailCertified Provider Credentialing Specialist (CPCS)Compliance Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Primary Source VerificationCredentialing Application SubmissionProvider Record MaintenanceExpiration Date MonitoringDocumentation Review

Soft Skills

Self-DrivenOrganizedMultitaskingCommunicationProblem-Solving

Tools & Technologies

PECOSAvailityVerityCredentialing Databases

Certifications & Qualifications

Certified Provider Credentialing Specialist (CPCS)

Industry Keywords

Health PlansPayersProvider NetworksAccreditation Standards

About the role

Key responsibilities & impact

Manage the full credentialing and re-credentialing process for assigned providers
Conduct primary source verification of licenses, board certifications, education, training and work history
Submit and track credentialing applications to health plans, payers and provider networks
Maintain accurate provider records in credentialing databases and electronic systems
Monitor expiration dates for licenses, DEA registrations, malpractice insurance and certifications to prevent lapses
Ensure compliance with state, federal and accreditation standards
Review provider applications for completeness and accuracy, and follow up on missing or incomplete documentation
Respond to payer inquiries and assist in resolving credentialing discrepancies or denials
Communicate credentialing status updates to providers and internal stakeholders
Identify opportunities to improve the efficiency, accuracy, and timeliness of credentialing processes

Requirements

What you’ll need

High School diploma or equivalent
2+ years of relevant credentialing experience
Working experience in CAQH, PECOS, Availity, Verity
Willingness to learn and build a process around onboarding new clients for payer claim enrollment and EFT enrollments
Self-driven and motivated with great attention to detail
Able to manage multiple priorities and meet deadlines
Comfortable with multitasking and working in a tech-driven environment
Organized and focused while navigating multiple systems
Able to handle sensitive and confidential information with discretion
Certified Provider Credentialing Specialist (CPCS) certification preferred

Benefits

Comp & perks

Paid vacation, sick time, and personal days
11 company paid holidays
Health, dental, and vision benefits, with employer HSA contribution
401(k) company match and profit sharing
STD, LTD and life insurance
Quarterly UberEats voucher
Monthly Fringe benefits
Professional development stipend