We are seeking an experienced and detail-oriented Interstate Credentialing Specialist to manage provider credentialing and licensing processes across multiple states.
Key Responsibilities
- Manage end-to-end interstate provider credentialing and recredentialing processes.
- Coordinate and track state medical licenses, renewals, and regulatory requirements across multiple states.
- Process and maintain provider enrollment with Medicare, Medicaid, and commercial payers.
- Prepare and submit credentialing applications and supporting documentation.
- Verify provider credentials, education, work history, certifications, malpractice coverage, and references.
- Maintain accurate records in credentialing databases and provider management systems.
- Ensure compliance with NCQA, CMS, Joint Commission, and state regulatory guidelines.
- Monitor credential expiration dates and proactively manage renewals.
- Liaise with physicians, healthcare facilities, insurance payers, and licensing boards to resolve credentialing issues.
Required Qualifications
- 2+ years of experience in provider credentialing, interstate credentialing, or medical staff services.
- Strong knowledge of CAQH, NPI, PECOS, Medicare, Medicaid, and commercial payer enrollment.
- Familiarity with state licensing boards and multi-state credentialing requirements.
- Experience with credentialing software and provider databases.
- Excellent communication, organizational, and follow-up skills.
- Ability to manage multiple priorities and meet deadlines.
- Knowledge of telehealth licensing and multi-state practice requirements.
Interested candidates can apply here or share your updated resume with [email protected] or connect using mob: 9686725753.
Pay: ₹25,000.00 - ₹45,000.00 per month
Application Question(s):
- Could you please confirm whether you have experience in interstate credentialing?
Work Location: Remote
