Payer Credentialing Specialist

Role Overview

The Payer Credentialing Specialist is responsible for managing all aspects of staff payer credentialing across Merakey. This role serves as the primary point of contact for facility and practitioner credentialing and re-credentialing processes, ensuring compliance with payer requirements and organizational standards.

What You Will Do

Ensure timely and accurate submission of initial and re-credentialing applications for all employed and contracted providers, maintain active Medicare and Medicaid enrollments, and manage provider records across various payer systems.

Why It Might Be a Fit

The ideal candidate will possess strong knowledge of credentialing processes, excellent written and verbal communication skills, and experience with MD-Staff credentialing system and maintaining provider data across various payer systems.

Requirements

• Associate Degree or two years equivalent work experience
• Minimum of two years of credentialing experience including work with CAQH and provider enrollment processes
• Strong knowledge of credentialing processes, including payer submissions, re-credentialing, and maintaining Medicare/Medicaid enrollments
• Strong computer proficiency, including Microsoft Excel, Word, and Outlook, along with solid organizational and time management skills
• Excellent written and verbal communication skills, with the ability to communicate effectively with internal and external stakeholders
• Experience with MD-Staff credentialing system
• Experience maintaining provider data across CAQH, PECOS, PROMISe, and other payer systems, ensuring accuracy and compliance

Benefits

• Comprehensive medical, dental, and vision coverage
• Retirement plan
• DailyPay
• On the Goga well-being platform
• Access Care.com
• Confidential counseling, legal, and financial services through Employee Assistance Program (EAP)
• Tuition reimbursement and educational partnerships
• Employee discounts and savings programs
• Access to Pryor Online Learning

Originally posted on Himalayas