Source Job

US

  • Manage provider credentialing and re-credentialing with commercial payers, Medicare, Medicaid, and managed care organizations.
  • Prepare and submit accurate medical claims with proper CPT, HCPCS, and ICD-10 coding to minimize denials and delays.
  • Reconcile payments, investigate denials, and maintain compliance with HIPAA and payer requirements.

Credentialing Medical Billing HIPAA Compliance EHR Systems

20 jobs similar to Medical Insurance Credentialing Specialist

Jobs ranked by similarity.

$56,000–$63,000/yr
US

  • Complete credentialing and re-credentialing applications for physicians, ancillary providers, and facilities with third-party payers and governmental programs.
  • Perform primary source verification, maintain CAQH profiles, and update credentialing databases accurately.
  • Partner with client liaisons and payers to manage enrollment status, follow up on applications, and communicate updates to providers and clients.

BerryDunn is a professional services firm providing tax, advisory, and consulting services to businesses, nonprofits, and government agencies across the US. The firm is known for its client-centered, people-first culture and commitment to diversity, learning, and well-being.

US

  • Prepare and manage provider credentialing and payer enrollment applications for commercial, Medicare, Medicaid, and other health plans.
  • Maintain accurate provider files including CAQH profiles, NPI information, state licenses, and other required documentation.
  • Monitor credentialing statuses through payer portals and communicate updates to leadership and providers.

Modena Health is a physician-led, hospitality-focused medical practice specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona and plans for national expansion. The company values collaboration, positivity, and growth, aiming to hire great people and help them find meaning in its mission.

Philippines

  • Manage end-to-end facility credentialing and privileging for providers across SNFs nationwide.
  • Prepare and track credentialing applications, facility packets, and compliance files.
  • Coordinate with facilities to resolve credentialing, access, and EMR issues in a timely manner.

Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for healthcare facilities, leveraging a global network to connect clients with qualified professionals. The company offers a flexible remote work environment where employees collaborate with an international team and contribute to a growing business.

US

  • Receive medical claims from healthcare providers or patients and verify supporting documentation to ensure completeness.
  • Interpret Explanation of Benefits (EOB) and CMS-1500 forms, then evaluate claims against program-specific business rules for approval or rejection.
  • Provide support to customer inquiries via phone, email, or fax while maintaining HIPAA compliance and meeting daily productivity goals.

IQVIA is a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. With operations in over 100 countries, they cultivate a diverse, collaborative culture focused on improving patient outcomes.

US

  • End-to-end credentialing and payer enrollment for multi-state providers across commercial and Medicaid plans.
  • Vendor governance and SLA performance management to ensure timely provider onboarding.
  • Delegated credentialing and audit readiness, including NCQA and MCO compliance.

Blackbird Health provides virtual and in-person mental health services for children across Pennsylvania, Virginia, New Jersey, and Maryland, focusing on a whole-child approach that integrates brain, body, and behavior. The company is clinician-founded and owned, with a collaborative, supportive, and innovative team that is expanding into new markets in 2027.

US

  • Interpret clinical documentation to accurately assign diagnosis and procedure codes for outpatient encounters.
  • Maintain current knowledge of ICD-10 and CPT coding systems and ensure documentation supports assigned codes.
  • Manage daily work queues and perform data and charge entry within patient accounting systems.

This partner company operates within an academic medical environment, providing healthcare services and supporting accurate outpatient coding. Their culture is supportive and collaborative, with a focus on high-quality healthcare operations and continuous learning.

Global

  • Execute day-to-day provider enrollment, credentialing, and licensing tasks under the guidance of Specialists and Team Leads.
  • Accurately input, maintain, and update provider data across credentialing databases and internal systems.
  • Identify and escalate issues, discrepancies, or complex cases to the appropriate team member in a timely manner.

Allara is a comprehensive women’s health provider specializing in expert, longitudinal care for hormonal, metabolic, and reproductive health. It is one of the fastest-growing women’s health platforms in the U.S., with a mission-driven, collaborative culture focused on bridging gaps in healthcare.

US

  • Serve as a supportive point of contact for onboarding providers, guiding them through paperwork and expectations.
  • Collect, verify, and review provider credentials, applications, and CAQH profiles for accuracy and completeness.
  • Maintain tracking records, update internal databases, and collaborate with cross-functional teams to meet provider start dates.

Privia Health is a technology-driven, national physician enablement company that partners with medical groups, health plans, and health systems to optimize practices and improve patient care. The company is led by top industry talent and exceptional physician leadership, with a culture that encourages employees to bring their whole selves to work.

$34–$34/hr
US

  • Review inpatient and outpatient records and assign accurate ICD-10, CPT, and HCPCS codes.
  • Maintain a minimum coding accuracy of 95% while meeting turnaround and quality standards.
  • Work fully remotely within the US supporting multiple medical facilities.

This position is listed on behalf of a partner company within a large healthcare network. They focus on health information management and clinical coding accuracy, offering a fully remote environment.

$18–$21/hr
US

  • Manage standard onboarding workflows for physical therapist enrollment across contracted payers and partner networks.
  • Review provider credentials, prepare application packets, and maintain accurate database records for compliant credentialing.
  • Communicate with insurance carriers and internal teams to ensure timely enrollment and resolve routine barriers.

Luna is revolutionizing the delivery of physical therapy by providing in-home care through a digital platform. As a start-up with supportive leadership, they offer opportunities for growth alongside a dedicated team.

US

  • Oversee credentialing workflows, quality, and compliance standards to ensure provider satisfaction and regulatory adherence.
  • Develop effective credentialing strategies based on data analysis, regulatory requirements, and operational observations.
  • Manage credentialing staff, provide coaching and feedback, and drive turnaround time improvement initiatives.

Sutherland is a global digital transformation company combining AI, automation, cloud engineering, and advanced analytics for iconic brands. It creates over 200 inventions and pairs human expertise with AI to unlock performance and deliver measurable results.

US

  • Respond to patient inquiries through chat, email, and internal messaging with clarity, warmth, and professionalism.
  • Break down complex topics (billing, CPT codes, coverage, device returns) into simple, patient-friendly explanations.
  • Document all interactions clearly and accurately, ensuring consistent follow-up until issues are fully resolved.

Salvo Health takes a new approach to help millions of Americans facing chronic health conditions, centered on chronic gut health and metabolic conditions. Backed by leading health care investors, Salvo's team includes board-certified physicians, dietitians, nurses, and therapists who provide evidence-based, continuous care.

$25–$30/hr
US

  • Code a high volume of outpatient encounters, including clinic visits, ancillary services, diagnostic testing, and outpatient surgery.
  • Assign E/M levels, apply NCCI edits and modifiers, and review clinical documentation in VA systems like CPRS and VistA.
  • Maintain 95% coding accuracy, protect patient information, and complete federal background investigation requirements.

Our partner is a healthcare organization that provides medical coding services for Veterans Affairs facilities. The company emphasizes mission-driven work, accuracy, and confidentiality while supporting veteran healthcare services across the United States.

US

  • Conduct audits of medical records for compliance with federal coding regulations and guidelines.
  • Provide education and training to providers on CPT, ICD-10, and HCPCS codes.
  • Act as an internal expert to ensure coding compliance with state and federal regulations.

Privia Health is a technology-driven national physician enablement company collaborating with medical groups, health plans, and health systems. It aims to optimize physician practices and improve patient experiences through cloud-based technology and scalable operations.

US

  • Own delegated credentialing operations across assigned payer relationships.
  • Manage payer audits, compliance reporting, and audit-ready credentialing files.
  • Support NP and group practice credentialing while partnering with internal teams.

Tava Health is reimagining mental health care to make it as accessible and stigma-free as a checkup, connecting patients with therapists and improving provider care. It is a fast-growing, mission-driven team leveraging technology to deliver high-quality mental health care to everyone.

Global

  • Manage the full revenue cycle from patient registration through claims resolution.
  • Accurately submit and track medical claims to various insurance payers.
  • Perform accounts receivable follow-up, identifying and resolving denied, underpaid, or unpaid claims.

Allara is a comprehensive women's health provider that offers expert, longitudinal care for hormonal, metabolic, and reproductive conditions. It is one of the fastest-growing women's health platforms in the U.S., trusted by thousands of women nationwide.

US

  • Code inpatient professional and nursing home services using CPT, ICD-10-CM, and HCPCS.
  • Apply E/M categories, NCCI edits, and modifiers accurately for surgical and evaluation services.
  • Maintain 95% accuracy and meet productivity standards while working with clinical documentation.

This partner company provides medical coding and billing services for healthcare facilities, including Veterans Affairs medical centers. It is an equal opportunity employer with a remote team focused on accuracy and compliance.

India

  • Monitor clearinghouse portals and resolve rejected medical claims daily.
  • Investigate rejection causes including coding errors and eligibility issues.
  • Correct claim information and resubmit to insurance payers for reimbursement.

Our partner is a healthcare revenue cycle management company focused on optimizing medical claims processing for providers. They offer a collaborative, inclusive work culture with opportunities for professional growth in a remote environment.

$39,000–$49,400/yr
US

  • Process incoming medical referrals, enter accurate data into medical management systems, and assign appropriate healthcare providers.
  • Review referrals for benefits and medical necessity, escalate sensitive cases for clinical assessment, and apply ICD-10 and CPT codes.
  • Communicate with military treatment facilities and civilian providers, respond to inquiries, and manage referral tasks within established timelines.

This position is listed on behalf of a partner company that manages all applications and next steps. The company supports healthcare service delivery by ensuring medical referrals are processed accurately and efficiently within a structured, collaborative remote team.

$30–$37/hr
US

  • Supervise and train the credentialing associate team to ensure high performance.
  • Document and refine insurance credentialing workflows and processes.
  • Collaborate with the Credentialing Team Lead and partners to monitor metrics and resolve issues.

BetterHelp is the world's largest online therapy service, connecting millions of people with licensed therapists to make mental healthcare more accessible. As part of Teladoc Health, it offers startup energy with the support of a large company and a diverse, collaborative culture.