Payer Credentialing Specialist

Payer Credentialing Specialist

Are you looking for an opportunity to advance your career while working with an extraordinary team? At Merakey, we put heart and soul into everything we do. We are seeking a Payer Credentialing Specialist to join our team.

Pay rate starting at $20/hr

This is a remote position available for candidates residing in PA, DE, MD, NJ, OH, FL, TX, and VA.

Position Details:

The Payer Credentialing Specialist is responsible for managing all aspects of staff payer credentialing across Merakey. This role serves as the primary point of contact for facility and practitioner credentialing and re-credentialing processes, ensuring compliance with payer requirements and organizational standards. The position reports directly to the Contracting and Credentialing Supervisor.

The Payer Credentialing Specialist will:

• Ensure timely and accurate submission of initial and re-credentialing applications for all employed and contracted providers
• Maintain active Medicare and Medicaid enrollments for all eligible providers
• Manage and update provider records across CAQH, PECOS, PROMISe, and other payer systems, ensuring accuracy and compliance
• Track and maintain all required documentation (e.g., licenses, DEA, malpractice insurance) to ensure records remain current
• Respond promptly to payer requests for additional or missing information to support credentialing processes
• Provide regular status updates on credentialing progress for new and existing providers
• Research and resolve credentialing-related claim issues, collaborating with operations and business teams
• Build and maintain strong working relationships with providers, program leadership, and support teams
• Adhere to all organizational policies, procedures, and standards
• Perform other duties as assigned

Benefits

Merakey offers generous benefits that promote well-being, financial security, and work-life balance, including:

• Comprehensive medical, dental, and vision coverage, plus access to healthcare advocacy support.
• Retirement plan -- both pre-tax and Roth (after-tax) options available for employee contributions.
• DailyPay -- access your pay when you need it!
• On the Goga well-being platform, featuring self-care tools and resources.
• Access Care.com for backup childcare, elder care, and household services.
• Confidential counseling, legal, and financial services through our Employee Assistance Program (EAP).
• Tuition reimbursement and educational partnerships.
• Employee discounts and savings programs on entertainment, travel, and lifestyle.
• Access to Pryor Online Learning for free online personal development classes.

About Merakey

Merakey is a non-profit provider of developmental, behavioral health, and education services. More than 8,000 employees provide support to nearly 40,000 individuals and families throughout 12 states across the country each year. Merakey strictly follows a zero-tolerance policy for abuse.

Merakey is proud to be an Equal Opportunity Employer! We deeply value diversity and do not discriminate on the basis of race, religion, color, national origin, ethnic background, sex, gender, gender identity, sexual orientation, age, marital status, veteran status, genetic information, or disability status. Moreover, we are committed to creating teams that reflect the diversity of the communities we serve and encourage applicants from underrepresented backgrounds to apply. Merakey welcomes all Veterans to apply!

• Associate Degree or two years equivalent work experience required; Bachelor's Degree preferred
• Minimum of two years of credentialing experience including work with CAQH and provider enrollment processes

The ideal candidate will possess:

• Strong knowledge of credentialing processes, including payer submissions, re-credentialing, and maintaining Medicare/Medicaid enrollments
• Strong computer proficiency, including Microsoft Excel, Word, and Outlook, along with solid organizational and time management skills
• Excellent written and verbal communication skills, with the ability to communicate effectively with internal and external stakeholders
• Experience with MD-Staff credentialing system
• Experience maintaining provider data across CAQH, PECOS, PROMISe, and other payer systems, ensuring accuracy and compliance