Credentialing Specialist

🕒 June 25

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Clarity RCM

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2017

🏥 Healthcare

🤝 B2B

⚕️ Healthcare Insurance

Healthcare • B2B • Healthcare Insurance

Clarity RCM is an outsourced revenue cycle management (RCM) company specializing exclusively in dermatology practices. They provide end-to-end medical billing services — including coding, claim submission, AR follow-up, denial management, payment posting, credentialing, compliance audits, and reporting — and also offer coaching and operational guidance to help practices scale. Clarity integrates with leading dermatology EMR/PM systems, processes over $600 million in dermatology claims annually across dozens of states, and positions itself as a dedicated B2B partner focused on accelerating collections and reducing aged receivables for dermatology providers.

📋 Description

• Own the full lifecycle of credentialing for physicians and advanced practice providers, including initial onboarding, primary source verification, re-credentialing, and ongoing monitoring • Verify education, training, licenses, board certifications, malpractice insurance, and work history with complete accuracy • Ensure all credentialing files meet NCQA, TJC, CMS, and payer-specific requirements • Prepare, submit, and track enrollment applications with commercial payers including BCBS, UHC, Aetna, and Cigna, as well as Medicare and Medicaid • Manage CAQH ProView including quarterly attestations and document maintenance • Process Medicare enrollments and updates through PECOS • Create structure in areas that currently have few or inconsistent processes • Organize credentialing inputs from multiple sources and turn them into clear workflows, trackers, and checklists • Track effective dates and panel statuses and communicate updates to internal stakeholders • Maintain accurate provider data across CAQH, PECOS, payer portals, and internal systems • Keep all credentialing records continuously audit-ready with complete and up-to-date documentation • Monitor expiring state licenses, DEA registrations, malpractice insurance, and board certifications

🎯 Requirements

• 2 to 3 years of hands-on medical credentialing or payer enrollment experience • Familiarity with CAQH, PECOS, payer portals, and credentialing software • Strong understanding of NCQA, TJC, CMS, and standard credentialing requirements • A track record of bringing order to complex or unstructured environments and building processes that scale • Ability to identify inconsistencies instantly and maintain clean, accurate files • Persistent and professional when gathering documentation or resolving gaps • Clear, concise, and confident written and verbal communication skills • Comfortable navigating multiple systems and adopting new tools • Ability to handle PHI and sensitive information with complete discretion • Process-driven, organized, proactive, resourceful, and committed to continuous improvement

🏖️ Benefits

• Competitive salary with benefits, commensurate with experience