About This Role
This role is for an experienced Credentialing Specialist to join a healthcare operations team, focusing on managing provider credentialing and payer enrollment. The specialist will ensure all applications are accurate, complete, and processed efficiently from start to finish.
Responsibilities
- Manage end-to-end provider credentialing and enrollment with Medicare, Medicaid, and commercial payers
- Handle provider applications, revalidations, recredentialing, updates, and terminations
- Track application status and follow up with payers to resolve delays, missing information, and rejections
- Maintain accurate credentialing trackers and prepare regular status and productivity reports
- Monitor pending applications and ensure cases are completed within required timelines
- Work closely with billing and operations teams to prevent enrollment-related denials and payment delays
- Ensure all credentialing activities follow payer requirements, regulatory guidelines, and internal SOPs
- Identify process gaps and help improve credentialing workflows, documentation, and team performance
Requirements
- 3–5 years of experience in U.S. healthcare credentialing and payer enrollment
- Strong knowledge of Medicare, Medicaid, and commercial payer enrollment processes
- Hands-on experience with CAQH ProView, NPPES, PECOS, and payer portals
- Experience with application tracking, reporting, payer follow-ups, and managing multiple cases
- Strong knowledge of credentialing documentation and requirements
- Good working knowledge of Microsoft Excel
- Strong written and verbal communication skills
- Ability to work independently, manage deadlines, and follow up consistently
Benefits
- Hybrid working environment
- Opportunity to work with U.S.-based healthcare clients and teams
- Exposure to healthcare technology and modern credentialing workflows
- Collaborative, performance-driven work environment
- Long-term career growth and development opportunities
Important Details
- Working Hours: U.S. Central Time (CST)
Application Process
- Send your resume with your cover letter on the body of the email and use "Credentialing Specialist - Your Name" as the subject line
About the Company
Simplibill is a healthcare technology company that helps providers and billing organizations improve their Revenue Cycle Management through technology, automation, and better workflows. Its platform integrates billing operations, reporting, and workflow management to enhance efficiency, reduce delays, and provide better visibility into healthcare operations.
