Credentialing Specialist

nimble solutions

. Manage end-to-end credentialing and recredentialing for providers across assigned client accounts .

Posted 9/15/2026full-timeRemote • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing credentialing and recredentialing processes for healthcare providers, ensuring compliance with Medicare, Medicaid, and commercial health plans. Proficient in maintaining organized records and communicating effectively with stakeholders to resolve issues and monitor expirations.

Highest-signal resume keywords

Credentialing ManagementPayer Enrollment ProcessesAttention to DetailMicrosoft Office ProficiencyCPCS Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CredentialingProvider EnrollmentPayer ApplicationsRecord KeepingCompliance MonitoringData VerificationCredentialing SoftwareMedicare EnrollmentMedicaid EnrollmentCAQH Profiles

Soft Skills

Organizational SkillsCommunication SkillsTime Management

Tools & Technologies

Credentialing SoftwareMicrosoft OfficePayer Portals

Certifications & Qualifications

CPCSCPMSM

Industry Keywords

Healthcare AdministrationRCM VendorMulti-Client EnvironmentCMS StandardsNCQA Standards

About the role

Key responsibilities & impact

Manage end-to-end credentialing and recredentialing for providers across assigned client accounts
Prepare, submit, and track payer enrollment and participation applications for Medicare, Medicaid, and commercial health plans
Verify provider credentials, including licenses, NPI, DEA, malpractice, CAQH profiles, and board certifications
Maintain detailed, organized records of credentialing activities within internal databases and client systems
Communicate with providers, payers, and internal teams to resolve credentialing issues or delays
Monitor upcoming expirations and initiate timely renewals to ensure continuous network participation
Collaborate with contracting and billing teams to align provider enrollment with payer contracts and claim submission readiness
Stay current with payer policies, CMS, and NCQA credentialing standards to ensure compliance
Generate credentialing status reports and provide updates to internal leadership and client contacts

Requirements

What you’ll need

Associate’s or Bachelor’s degree preferred (Healthcare Administration or related field)
Minimum 2 years of credentialing or provider enrollment experience, preferably with an RCM vendor or multi-client environment
Familiarity with Medicare/Medicaid enrollment processes, PECOS, CAQH, and payer portals
Strong organizational and documentation skills with attention to detail
Excellent written and verbal communication
Ability to manage multiple client accounts and deadlines simultaneously
Proficient in Microsoft Office and credentialing/enrollment software
CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified Professional Medical Services Management) preferred but not required
Must maintain confidentiality of provider and client data at all times

Benefits

Comp & perks

Full-time employment
Remote work setting
Opportunities for growth
Cutting-edge technology
Cross-functional collaboration