Credentialing Specialist

Interpulse Global is a medical billing company dedicated to supporting healthcare providers through billing, coding, and credentialing services. We are seeking a detail-oriented and organized professional to join our credentialing team. The Credentialing Specialist will be responsible for managing provider enrollment and credentialing processes with various insurance payers. This role ensures that providers are properly approved and active, enabling them to bill without delays.

Key Responsibilities
- Complete and submit credentialing and re-credentialing applications to insurance payers.
- Manage provider enrollment with Medicare, Medicaid, and commercial insurance companies.
- Maintain and update provider profiles on CAQH.
- Track application status and conduct regular follow-ups with payers.
- Monitor expiration dates for licenses, DEA registrations, board certifications, and malpractice insurance.
- Collect and verify provider documents and credentials to ensure accuracy.
- Maintain accurate records and credentialing trackers for all providers.
- Communicate effectively with providers and clients regarding application progress and any missing documentation.
- Ensure compliance with payer requirements and regulatory standards throughout the credentialing process.

Required Qualifications
- Minimum of 1 year of experience in provider credentialing and enrollment.
- Working knowledge of CAQH, PECOS, NPPES, and various payer portals.
- Solid understanding of the credentialing and contracting process within healthcare.
- Strong organizational and time-management skills to handle multiple providers and deadlines simultaneously.
- Excellent follow-up and communication skills in English.
- High attention to detail and a strong commitment to maintaining confidentiality.

Only shortlisted candidates will be contacted for further steps in the hiring process.