Credentialing Specialist

H2 Health

. Coordinate provider and facility credentialing, recredentialing, and enrollment processes with insurance payers, including Medicare, Medicaid, and commercial insurance plans.

Posted 11/3/2026full-timeRemote • Florida • 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 processes, including provider enrollment and insurance payer coordination. Proficient in maintaining accurate records and ensuring compliance with regulations while effectively communicating with clinicians and insurance representatives.

Highest-signal resume keywords

Healthcare CredentialingProvider EnrollmentCAQH System ProficiencyAttention To DetailMicrosoft Office Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Credentialing ProcessesProvider Profile ManagementNPI ApplicationsInsurance CredentialingMedallion System ProficiencyDocument VerificationRecordkeepingApplication TrackingCompliance ManagementAdministrative Support

Soft Skills

Organizational SkillsWritten CommunicationVerbal CommunicationIndependenceAccountability

Tools & Technologies

MedallionCAQHElectronic Recordkeeping

Industry Keywords

Healthcare AdministrationInsurance PayersMedicareMedicaidCredentialing Documentation

About the role

Key responsibilities & impact

Coordinate provider and facility credentialing, recredentialing, and enrollment processes with insurance payers, including Medicare, Medicaid, and commercial insurance plans.
Review credentialing information in Medallion, verifying provider details, credentialing status, and supporting documentation.
Maintain and update provider profiles in the CAQH system, including required attestations and supporting documentation.
Assist clinicians with NPI applications and updates.
Monitor professional licenses, certifications, expiration dates, and other required credentialing documentation.
Add newly hired providers to applicable insurance payer rosters and remove terminated providers as required.
Track credentialing applications, renewals, outstanding documentation, and payer enrollment status.
Communicate with clinicians, insurance representatives, and internal departments to obtain information and resolve credentialing discrepancies.
Assist clinicians with fingerprinting and other credentialing documentation.
Maintain confidential, accurate, and organized credentialing records in accordance with applicable regulations and company policies.
Support additional administrative and compliance-related tasks as needed.

Requirements

What you’ll need

High school diploma or equivalent preferred.
Previous experience in medical office administration, healthcare credentialing, provider enrollment, or a related healthcare administrative role preferred.
Familiarity with CAQH, NPI applications, insurance credentialing, and payer enrollment processes preferred.
Ability to review and interpret provider credentialing records in electronic platforms, including Medallion or similar systems.
Strong attention to detail, organizational skills, and ability to manage multiple deadlines.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office applications and electronic recordkeeping.
Ability to work independently in a remote setting while maintaining strong communication and accountability.
Commitment to protecting confidential provider and patient information.

Benefits

Comp & perks

Medical, dental, and vision insurance
Paid time off (PTO) and paid holidays
401(k) retirement plan
Professional development and growth opportunities
A collaborative and supportive team environment
Full-time remote work