Provider Credentialing Specialist

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Provider Credentialing Specialist based in United States.

This remote role supports critical healthcare operations within a mission-driven federal health program. You’ll help ensure healthcare providers are properly credentialed, compliant, and ready to deliver services to program members. The position combines detailed credentialing work with cross-functional collaboration across providers, quality teams, and operational stakeholders. You’ll manage documentation, verification, onboarding, and recredentialing activities while helping maintain high standards of regulatory compliance. Your work will directly contribute to provider readiness, operational accuracy, and reliable healthcare delivery. The environment offers flexibility, professional growth, and the opportunity to contribute to meaningful public health outcomes.

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Accountabilities:

• Lead day-to-day provider credentialing and recredentialing activities, supporting provider onboarding, regulatory compliance, and operational readiness.
• Collaborate with healthcare providers, credentialing teams, quality staff, and operational leaders to ensure applications, verifications, and supporting documentation are complete and accurate.
• Conduct Primary Source Verification (PSV) and validate provider licenses, certifications, and other required credentials.
• Prepare and maintain credentialing files and documentation for committee review, ensuring records remain accurate, organized, and up to date.
• Apply credentialing systems, documentation standards, and quality review processes to support consistent provider management operations.
• Work in accordance with applicable regulatory and accreditation standards, including CMS and NCQA requirements.
• Maintain confidentiality, manage deadlines effectively, and support accurate reporting and provider credentialing workflows.
• Contribute to continuous improvement across credentialing processes and help ensure providers remain compliant with organizational and program requirements.

Requirements

• High school diploma required; an associate or bachelor’s degree in a relevant field is preferred.
• At least 1 year of related experience, with 2+ years of healthcare credentialing experience preferred.
• Practical knowledge of initial credentialing, recredentialing, Primary Source Verification, provider onboarding, and credentialing documentation requirements.
• Familiarity with healthcare regulatory and accreditation standards, particularly CMS and NCQA.
• Strong attention to detail and a highly organized approach to managing documentation, deadlines, and multiple credentialing activities.
• Excellent written and verbal communication skills, with the ability to collaborate effectively with providers and internal stakeholders.
• Ability to handle confidential information professionally and work independently in a remote environment.
• Must be able to obtain and maintain an MBI (T2) background/public trust requirement.
• U.S. citizenship is not required.
• Ability to travel less than 10% as needed.

Benefits

• Estimated annual compensation of $46,750–$63,250, with actual pay determined by experience, geographic location, and applicable contractual requirements.
• Fully remote work with a full-time, 40-hour workweek.
• Flexible work arrangements designed to support work-life balance.
• Medical plan options, including plans with Health Savings Accounts, plus dental and vision coverage.
• 401(k) plan with employer matching and pre-tax and post-tax contribution options.
• Paid time off, including vacation, sick and personal leave, plus paid holidays.
• Typically 15 days of paid leave per calendar year for new employees, prorated based on start date, along with 10 paid holidays.
• Paid family leave of up to 160 hours within a rolling 12-month period for eligible employees.
• Short- and long-term disability coverage, life insurance, accidental death and dismemberment coverage, personal accident insurance, critical illness coverage, and business travel and accident insurance.
• Career development resources, learning opportunities, and internal mobility support.
• Opportunity to build expertise in healthcare credentialing and provider operations while contributing to mission-focused healthcare delivery.

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How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

 Why Apply Through Jobgether? 

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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