Credentialing Specialist (Fully Remote)

Description

About Aspirion

At Aspirion, our mission is simple and meaningful: to help healthcare providers get paid accurately,

quickly, and transparently for the care they deliver. By combining deep human expertise with advanced

technology and AI, we are helping make healthcare more affordable and accessible for everyone.

For more than two decades, Aspirion has been a market leader in revenue cycle services, specializing in

some of the most complex and high impact areas of reimbursement. From challenging denials and zero

balance reviews to aged accounts receivable, motor vehicle accident claims, workers’ compensation,

Veterans Affairs, and out of state Medicaid, we take on the work that others cannot solve and deliver real

results for our clients. At the heart of that success is our team. Our teammates are the foundation of

everything we do. With more than 1,400 individuals across the organization, we are united by a shared

commitment to delivering exceptional outcomes and creating meaningful impact for the hospitals and

health systems we serve.

We are building a results driven environment where high performance, collaboration, and continuous

growth are both expected and supported. The people who thrive here bring a growth mindset, stay open to

new technology and collaborate across teams to solve problems. You will have the opportunity to work

alongside a talented and driven team, engage with innovative technology, and play a direct role in solving

complex challenges that matter.

Joining Aspirion means more than taking a job. It means being part of a team that is shaping the future of

healthcare operations while making a measurable difference for providers and patients alike.

About the Role

Impact you will make

The Credentialing Specialist is responsible for coordinating and maintaining all aspects of provider

credentialing, recredentialing, enrollment, and data management activities. This role ensures healthcare

providers meet all regulatory, payer, and organizational requirements to maintain active participation with

commercial and government insurance plans. The Credentialing Specialist serves as a liaison between

providers, payers, internal departments, and external organizations to ensure timely and accurate

credentialing and enrollment processes.

What you will do

• Manage the initial credentialing, recredentialing, and provider enrollment processes as assigned.

• Prepare, submit, and monitor credentialing applications to hospitals, health plans, government

payers, and other credentialing entities.

• Maintain provider information within credentialing databases and ensure accurate and current records.

• Track credential expiration dates, including licenses, certifications, DEA registrations, malpractice

insurance, and other required documentation.

• Proactively obtain renewal documentation to prevent credentialing lapses.

• Monitor application status and follow up with payers and credentialing organizations for timely processing.

• Maintain compliance with federal, state, payer, and organizational credentialing requirements.

• Conduct primary source verification as required by accreditation and regulatory standards.

• Review provider files for completeness and accuracy before submission.

• Assist with provider enrollment, revalidation, and demographic updates with Medicare, Medicaid,

and commercial insurance carriers.

• Respond to credentialing inquiries from providers, leadership, clients, and payer representatives.

• Prepare credentialing reports and provide status updates to leadership as requested.

• Support audits and accreditation reviews by maintaining organized and compliant provider files.

• Collaborate with internal departments to resolve credentialing and enrollment issues impacting

provider participation or reimbursement.

• Maintain confidentiality of sensitive provider and organizational information.

What you will bring

• Strong understanding of credentialing, provider enrollment, and recredentialing processes.

• Knowledge of Medicare, Medicaid, and commercial payer requirements.

• Familiarity with CAQH, NPPES, PECOS, and payer enrollment portals.

• Excellent organizational skills with the ability to manage multiple deadlines simultaneously.

• Strong attention to detail and commitment to accuracy.

• Effective verbal and written communication skills.

• Ability to work independently and prioritize workload in a fast-paced environment.

• Proficiency with Microsoft Office Suite, including Excel, Word, and Outlook.

• Experience working with credentialing databases and provider management systems preferred.

• Strong problem-solving and follow-up skills.

What we would like to see

• High school diploma or equivalent.

• Minimum of 2 years of credentialing, provider enrollment, healthcare administration, or related

experience.

• Associate or bachelor's degree in healthcare administration, Business Administration, or a

related field preferred.

• Certified Provider Credentialing Specialist (CPCS) designation or willingness to obtain

certification.

• Experience credentialing providers across multiple states and payer networks.

• Experience within healthcare revenue cycle management, physician practice management, or

healthcare consulting organizations.

Core expectations

• Timely completion of credentialing and enrollment applications.

• Maintenance of provider participation without lapses in credentialing.

• Accuracy and completeness of provider records.

• Compliance with regulatory, payer, and organizational requirements.

• Achievement of departmental service level agreements and performance metrics.

• Demonstrate integrity and ethics in day-to-day tasks and decision making, operate effectively in the environment and the environment of the work group, maintain a focus on self-development and seek continuous feedback and learning opportunities

• Support Compliance Program by adhering to policies and procedures pertaining to HIPAA, GLBA, FCRA, and other laws applicable to business practices; this includes becoming familiar with Code of Ethics, attending training as required, notifying management when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations

• US remote-based colleagues are not permitted to work from a location outside of the United States, at any time, without prior, written approval.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer

The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position. This position may be required to perform other duties. If such work becomes a permanent and regular part of the job, a new description will be prepared.

Aspirion is an Equal Opportunity Employer and does not discriminate on the basis of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, gender identity, military veteran status, or any other characteristic protected by law.