Credentialing Specialist Jobs

Aria Care Partners

Location:
United States, Overland Park

Category:
Office Administration

Contract Type:
Not provided

Salary:

Not provided

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Job Description:

The Credentialing Specialist will be responsible for timely submission and follow-up for institutional and individual provider credentialing, contracting, and re-credentialing with health insurance payors across multiple states and service lines. Assists in verifying and monitoring credentials of healthcare providers and completing facility applications as needed. Maintains confidential files of providers records to meet company and compliance standards. This position requires communication with physicians, outside payors and facilities, and in-house departments such as billing and scheduling.

Job Responsibility:

Prepare and submit credentialing applications and supporting documentation for the purpose of enrolling groups and providers with Commercial, Medicare, and Medicaid networks
Follow up on the status of applications for providers with payers, tracking progression of pending and completed work
Maintains accurate and up-to-date database of information including provider credentials and payer statuses
Works closely with internal teams to communicate approvals and work through denials as necessary
Maintains knowledge of current payer requirements across multiple states and service lines
Maintain strict level of confidentiality and HIPAA compliance
Familiarity with state licensing requirements and provider onboarding tasks
Familiarity with various payer portals and CAQH
Contact providers and payers, by phone or email, for updates and/or to request missing information
Ensure group and provider information is current/accurate with health insurance payers
Assist with facility credentialing applications as needed

Requirements:

Minimum two years of health insurance credentialing experience preferred
Prior data management/data integrity experience preferred
Associates degree preferred
Proficient with Microsoft Office, including Excel, Word, and Outlook
Excellent organization and communication skills
Quick thinking, positive, and professional, with demonstrated problem solving, attention to detail, and critical thinking skills
Ability to work independently, set priorities, and meet deadlines
Adapt to changes in work environment, manage competing demands and deal with frequent change, delays, or unexpected events
Able to work in a team environment

What we offer:

PTO and Paid Holidays for FT Employees
401k Retirement Plan with Company Match
Insurance programs including medical, dental, vision, company match for your HSA, FSA, company-paid EAP, and life and disability insurance, and more

Additional Information:

Job Posted:
December 06, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Credentialing Specialist