Credentialing Specialist

Credentialing SpecialistGTM Physician Partners is a national medical practice advisory firm, based out of Richmond, VA, dedicated to supporting physicians as they launch and manage successful medical practices. A core component of our service offering is provider and practice credentialing. We are seeking a highly organized, detail-oriented Credentialing Specialist to manage the full credentialing lifecycle for assigned clients.In this role, you will be responsible for submitting, monitoring, and maintaining provider and practice credentials with commercial insurance carriers, Medicare, Medicaid, and other regulatory entities. The ideal candidate is reliable, proactive, and experienced with credentialing platforms such as CAQH, PECOS, NPPES, and major payer portals, with a strong ability to follow through and communicate effectively.This is a remote, work-from-home opportunity offering significant flexibility and autonomy. If you are a self-starter who thrives in an independent work environment, we will provide the tools and support you need to succeed—along with the trust to manage your own workflow and schedule.The position begins at approximately 20 hours per week, with the option to transition to full-time in the future, if desired. Compensation ranges from $23–$25 per hour, depending on experience.Key ResponsibilitiesComplete initial credentialing and recredentialing applications for individual providers and group practicesMaintain accurate and current provider information in CAQH, NPPES, PECOS, and payer portalsSubmit enrollment applications to commercial payers, Medicare, Medicaid, and managed care organizationsTrack application status and proactively follow up with payers to ensure timely processing and approvalReview provider documentation for completeness, accuracy, and compliance (licenses, certifications, malpractice insurance, etc.)Communicate with providers to obtain required information, documentation, and signaturesMaintain credentialing trackers, spreadsheets, and timelines to ensure deadlines are metAssist with payer contracting and network participation updates as neededEnsure compliance with organizational policies and all applicable state and federal regulationsProvide consistent, thorough status updates and communication to clientsQualificationsPrior experience in credentialing or healthcare administration, requiredExperience credentialing with multiple payers, including Aetna, Cigna, BCBS, UnitedHealthcare, Medicare, and Medicaid, preferredWorking knowledge of CAQH, PECOS, NPPES, payer portals, and credentialing processesExceptional attention to detail and accuracyStrong written and verbal communication skillsAbility to manage multiple priorities independently in a remote environmentProficiency with spreadsheets and credentialing tracking tools