Credentialing Specialist

Credentialing Specialist

41.6K-54K/yr + $7,500 Sign-On Bonus

Daily Lunch Catering

️ Comprehensive Benefits including medical, dental, vision, life insurance, disability, legal services, pet insurance & more.

Monday to Friday | Tempe, AZ 85288 (onsite)

Position Overview

The Credentialing Specialist plays a critical role in supporting revenue cycle operations by ensuring healthcare providers are properly enrolled with governmental and commercial payers. This position is responsible for managing the end-to-end enrollment process, including application submission, payer communication, and ongoing maintenance to ensure timely and accurate claim reimbursement.

This is a detail-oriented, high-volume role requiring strong organizational skills, the ability to navigate payer systems, and a proactive approach to problem-solving.

Responsibilities

• Manage the full lifecycle of provider enrollment, including new enrollments, updates, and revalidations with Medicare, Medicaid, and commercial payers
• Coordinate and support electronic setup processes, including EDI (claims submission), EFT (payments), and ERA (remittance advice)
• Ensure all enrollment applications are complete, accurate, and compliant prior to submission, including obtaining required signatures and documentation
• Serve as a primary liaison to payers for enrollment status, troubleshooting, and issue resolution
• Monitor payer portals, enrollment processes, and document transmissions to track progress and resolve delays
• Track and maintain internal records, including licenses and enrollment data, to ensure consistency and audit readiness
• Support audits and quality checks related to provider enrollment and compliance

Qualifications

• High school diploma or GED required
• Minimum of 3 years of provider enrollment, credentialing, or related healthcare experience required
• Experience working with governmental and commercial payers (Medicare, Medicaid, etc.)
• Familiarity with EDI, EFT, and ERA processes is a plus
• Strong attention to detail with the ability to manage high-volume, deadline-driven work
• Excellent communication and interpersonal skills, particularly when working with external payer representatives
• Proficiency in Microsoft Office (Word, Excel, Outlook)
• Ability to prioritize tasks independently and adapt to changing regulatory requirements

Equal Opportunity Employer/Veterans/Disabled

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The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

The California Fair Chance Act

Los Angeles City Fair Chance Ordinance

Los Angeles County Fair Chance Ordinance for Employers

San Francisco Fair Chance Ordinance