Join as a Provider Credentialing Specialist in Iowa (Remote Opportunity)
Are you detail-oriented and passionate about healthcare administration? We’re hiring a Provider Credentialing Specialist to join our team in Iowa, supporting our urgent care and primary care operations. As a Provider Credentialing Specialist, you’ll ensure accurate, efficient provider credentialing and maintain smooth billing processes by verifying provider licensure, credentials, and payer enrollments.
This role is ideal for professionals who thrive on organization, accuracy, and collaboration—helping maintain compliance and improve healthcare operations. The Provider Credentialing Specialist will also work closely with billing and HR teams to streamline provider onboarding, renewals, and payer communications.
Why Work as a Provider Credentialing Specialist
As a Provider Credentialing Specialist, you’ll play a key role in maintaining the integrity and compliance of provider data across multiple healthcare systems. You’ll manage credentialing and contracting with payers, ensure providers are properly enrolled, and help optimize claim processing. This role offers a dynamic work environment, professional growth, and a chance to directly impact the efficiency and success of healthcare delivery.
Key Responsibilities of the Provider Credentialing Specialist
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Enroll providers with payors and clearinghouses to ensure accurate claim submissions.
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Manage contracting, revalidation, CAQH maintenance, and Medicare/Medicaid enrollment.
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Maintain databases of provider information and coordinate reports with accrediting and licensing agencies.
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Collaborate with the billing department to prevent non-compliant or questionable claims.
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Review claims data for rejections and resolve credentialing-related issues.
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Maintain and update provider credentialing information with all payors and systems.
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Handle denials caused by credentialing errors and assist in resolution.
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Maintain the MODIO provider certification system and CAQH profiles.
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Update insurance eligibility portals such as Availity and Trizetto.
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Support HR with onboarding to ensure all documents are completed prior to hire.
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Track and renew medical licenses, board certifications, DEA, and related credentials.
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Maintain professional relationships with payors to support revenue cycle operations.
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Ensure compliance with HIPAA and credentialing regulations.
Qualifications for the Provider Credentialing Specialist Role
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Education: Associate degree preferred.
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Experience:
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2+ years of provider credentialing experience (required).
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Experience in billing, claims, or insurance within a medical office (preferred).
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Certifications: Certified Professional Biller (CPB) or Certified Professional Coder (CPC) preferred.
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Strong understanding of healthcare insurance rules, HIPAA compliance, and RHC credentialing guidelines.
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Proficiency in MS Word, Excel, and other office applications.
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Excellent data entry, organization, and multitasking skills.
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Ability to work independently and meet deadlines.
Schedule and Work Details
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Hours: Flexible 8-hour shifts, Monday–Friday.
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Location: Remote (Iowa-based applicants preferred).
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Work Type: Full-time role in a fast-paced, collaborative healthcare environment.
Why You’ll Love Being a Provider Credentialing Specialist Here
This Provider Credentialing Specialist position lets you combine your administrative expertise with healthcare purpose — ensuring smooth provider onboarding, compliance, and revenue optimization. If you value accuracy, teamwork, and growth in the medical field, this opportunity offers a rewarding and flexible environment to excel.