Credentialing Specialist

🔥 22 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 11%

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.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

nimble solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💼 Consulting

📦 Logistics

🛡️ Insurance

Consulting • Logistics • Insurance

nimble solutions is a company focused on innovative online solutions, offering services related to payment processing, account management, and invoicing. It leverages web-based technologies to provide efficient and user-friendly platforms for managing financial transactions and accounts. The company aims to simplify complex billing and payment processes for businesses.

📋 Description

• Manage end-to-end credentialing and recredentialing for providers across assigned client accounts • Prepare, submit, and track payer enrollment and participation applications for Medicare, Medicaid, and commercial health plans • Verify provider credentials, including licenses, NPI, DEA, malpractice, CAQH profiles, and board certifications • Maintain detailed, organized records of credentialing activities within internal databases and client systems • Communicate with providers, payers, and internal teams to resolve credentialing issues or delays • Monitor upcoming expirations and initiate timely renewals to ensure continuous network participation • Collaborate with contracting and billing teams to align provider enrollment with payer contracts and claim submission readiness • Stay current with payer policies, CMS, and NCQA credentialing standards to ensure compliance • Generate credentialing status reports and provide updates to internal leadership and client contacts

🎯 Requirements

• Associate’s or Bachelor’s degree preferred (Healthcare Administration or related field) • Minimum 2 years of credentialing or provider enrollment experience, preferably with an RCM vendor or multi-client environment • Familiarity with Medicare/Medicaid enrollment processes, PECOS, CAQH, and payer portals • Strong organizational and documentation skills with attention to detail • Excellent written and verbal communication • Ability to manage multiple client accounts and deadlines simultaneously • Proficient in Microsoft Office and credentialing/enrollment software • CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified Professional Medical Services Management) preferred but not required • Must maintain confidentiality of provider and client data at all times

🏖️ Benefits

• Full-time employment • Remote work setting • Opportunities for growth • Cutting-edge technology • Cross-functional collaboration