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Credentialing Specialist / Administrator

4 hours, 5 minutes ago
South Africa, United States
Full-time
Junior
Human Resources
Operations
Apply Now
Reworks Solutions

Reworks Solutions

ReWorks Solutions provides rigorously vetted, native English-speaking remote professionals backed by white-glove management and proactive support.

Internet Software & Services
View All Jobs 25

Description

  • Manage the credentialing and recredentialing process for healthcare providers to ensure compliance with regulatory standards.
  • Collect, verify, and maintain documentation of licenses, certifications, and educational qualifications for clinical staff.
  • Submit and track credentialing applications with insurance payers and support provider onboarding.
  • Monitor credentialing status, including expiration dates and renewal timelines, to keep records current.
  • Support adherence to state and federal regulations so providers meet qualifications for practice.
  • Maintain comprehensive credentialing files and assist during audits and evaluations.
  • Coordinate with HR and leadership on updates related to new hires and terminations.
  • Communicate with payers, compliance teams, and providers to resolve credentialing issues.

Requirements

  • Associate's degree in healthcare administration or a related field; Bachelor's degree preferred.
  • Prior experience in credentialing, preferably in a healthcare, behavioral health, or ABA setting.
  • Strong knowledge of medical licensing, insurance enrollment processes, and provider credentialing standards.
  • Excellent organizational skills with keen attention to detail and the ability to manage multiple projects.
  • Strong verbal and written communication skills for stakeholder interaction.
  • Proficiency with Microsoft Office or Google Workspace and comfort using credentialing software.
  • Ability to work independently and maintain productivity in a remote work environment.

Benefits

  • Full-time remote work from home.
  • Comfortable working U.S. hours (9am-5pm EST).
  • Fraud disclaimer and official communication policy to help applicants verify legitimate recruitment contact.

Interested in this position?

Apply directly on the company website

Apply Now

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