Insurance Credentialing Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🔒 Insurance

👻 Ghost score 24%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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HelpSquad

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2014

🏥 Healthcare

🤝 B2B

🏢 Enterprise

💰 $500k Angel Round - HelpSquad Health on 2015-05

Healthcare • B2B • Enterprise

HelpSquad is a US-managed, HIPAA-compliant provider of virtual medical assistants and healthcare BPO services. It supplies trained, vetted remote staff for scheduling, patient intake, insurance verification, prior authorizations, medical billing and revenue cycle management, call center support (including 24/7 and after-hours), medical scribing, and AI-enabled patient support and knowledge systems. HelpSquad offers managed teams, white-label reseller services, and specialty support for practices and organizations ranging from solo clinicians to multi-location medical groups, hospital systems, dental practices, behavioral health, and in-home care; it emphasizes compliance (BAA signed at company level), quality vetting, and US-based oversight.

📋 Description

• Manage the full credentialing lifecycle, including initial payer enrollment, contracting, recredentialing, revalidation, and ongoing payer participation across multiple payers and states • Prepare, submit, and track applications from initial submission through approval and confirmed effective date • Build and maintain CAQH ProView profiles, including initial setup, attestations, and reattestations • Ensure provider information is accurate and consistent across CAQH, payer portals, and internal records • Maintain complete and current provider files, including NPI Type 1 and Type 2, taxonomy codes, state licenses, DEA registrations, board certifications, malpractice insurance, and provider demographics and practice information • Submit and manage Medicare enrollment through PECOS • Complete enrollment with state Medicaid programs and managed-care plans, as well as commercial and behavioral health payers • Monitor pending, incomplete, returned, and rejected applications and follow up proactively through payer portals and provider-enrollment phone lines • Resolve enrollment issues and follow applications through to an approved effective date • Maintain a centralized credentialing tracker and provide weekly status reports • Monitor upcoming recredentialing, revalidation, license, certification, and other expiration deadlines to prevent lapses • Escalate payer delays or issues when necessary • Coordinate with billing to confirm payer enrollment and effective dates so claims are not submitted before a provider is properly active • Maintain accurate, organized, and audit-ready credentialing documentation

🎯 Requirements

• Hands-on experience with CAQH ProView • Hands-on experience with NPPES / NPI Registry • Hands-on experience with PECOS for Medicare enrollment • Hands-on experience with state Medicaid provider portals • Hands-on experience with commercial payer portals, including Availity and payer-specific systems • Experience with provider credentialing and payer enrollment processes • Knowledge of taxonomy codes and provider enrollment documentation • Knowledge of payer-specific enrollment and credentialing requirements • Proven experience in provider credentialing and payer enrollment • Strong understanding of Medicare, Medicaid, commercial, and behavioral health payer enrollment • Excellent attention to detail and documentation management • Strong follow-up skills and persistence when working with payers • Ability to manage multiple providers, payers, states, and deadlines simultaneously • Strong organizational and time-management skills • Ability to identify missing or inconsistent information before it causes enrollment delays • Comfortable communicating with payer representatives and provider enrollment departments • Self-directed and able to manage the credentialing process with minimal supervision

🏖️ Benefits

• Competitive hourly rate • On-time payments, every time • Payments processed via Wise • Direct client training provided • Dedicated Account Manager as your point of contact • Stable, long-term placement with a growing U.S.-based company • Exposure to a wide range of modern SaaS platforms • Potential for increased responsibilities as the company scales • Tenure recognition for long-term team members • Clear escalation paths • 100% remote — work from home • Supportive team culture across all accounts • Potential for increased hours or additional accounts based on performance • Build your U.S. industry experience • Exposure to multiple practice types and platforms • Strengthen your resume with verified, legitimate U.S. client experience • Recognition for loyalty and long-term growth