Credentialing Specialist

6 days, 14 hours ago
Full-time
Junior
Operations
Metro Vein Centers

Metro Vein Centers

Metro Vein Centers specializes in providing advanced, minimally invasive treatments for varicose and spider veins, ensuring personalized care from board-certified specialists to help patients regain healthy and attractive legs.

Health Care Providers & Services
51-250
Founded 2008

Description

  • Submit and track provider enrollments for Medicare, Medicaid, and commercial payers to secure effective dates.
  • Identify and pursue network expansion opportunities across additional payer products, plans, and service locations.
  • Maintain CAQH attestations and accurate provider data in payer portals and internal credentialing systems.
  • Monitor revalidations and recredentialing timelines to prevent participation lapses.
  • Support onboarding for new providers by gathering documents and coordinating NPI, taxonomy, and location setup.
  • Respond to payer requests, provide additional documentation, and resolve application issues promptly.
  • Escalate complex credentialing issues to the Supervisor of Credentialing as needed.
  • Participate in special projects and collaborate with Recruitment, Clinical leadership, and RCM.

Requirements

  • 2+ years of experience in provider credentialing and/or payer enrollment in a physician group, MSO, health plan, or hospital setting.
  • Hands-on experience with CAQH, Medicare PECOS, and payer portals such as Availity.
  • Working knowledge of Medicare, Medicaid, and commercial enrollment rules.
  • Experience using credentialing systems such as MD-Staff or Cactus.
  • Proficiency with Excel or Google Sheets.
  • Strong data accuracy and documentation skills across multiple systems.
  • Effective written and verbal communication with payers, providers, and internal stakeholders.
  • Ability to prioritize in a high-volume environment, meet deadlines, and follow SOPs with minimal supervision.
  • Self-starter mindset with ownership and follow-through in a remote work setting.
  • High school diploma or equivalent required.

Benefits

  • Medical, dental, and vision insurance.
  • 401(k) with company match.
  • Paid time off plus paid company holidays.
  • Company-paid life insurance.
  • Short-term disability insurance.
  • Employee Assistance Program (EAP).
  • Career growth and development opportunities.

Interested in this position?

Apply directly on the company website

Apply Now

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