Insurance Credentialing Specialist

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TYPE OF WORK

Full Time

SALARY

5

HOURS PER WEEK

40

DATE UPDATED

Sep 18, 2026

JOB OVERVIEW

About the Role
Our physician group practice is seeking an Insurance Credentialing Specialist to manage provider enrollment and payer credentialing for our growing practice. This is a fully remote position. We operate in PST (Pacific Time Zone). Company is based in California.

Responsibilities

Manage initial credentialing and recredentialing for physicians and advanced practice providers with commercial payers, Medicare, and Medicaid
Complete and submit CAQH profiles and maintain ongoing attestations
Track expiring licenses, DEA registrations, board certifications, and malpractice coverage; ensure timely renewals
Monitor application status with payers and follow up until enrollment is finalized
Maintain credentialing files in compliance with NCQA, CMS, and payer specific standards
Coordinate with medical staff offices for privileging when applicable
Update provider data in credentialing software and practice management systems
Serve as the point of contact for payer enrollment issues affecting claims and reimbursement
Support delegated credentialing audits and internal compliance reviews

Qualifications

2 to 4 years of experience in provider credentialing or payer enrollment within a physician practice, health system, or payer setting
Working knowledge of CAQH, PECOS, NPPES, and state Medicaid enrollment portals
Familiarity with NCQA credentialing standards and CMS provider enrollment requirements
Strong attention to detail and ability to manage multiple provider files with competing deadlines
CPCS (Certified Provider Credentialing Specialist) certification preferred, not required
Experience with credentialing softwares

SKILL REQUIREMENT
Medical Insurance Credentialing
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