Introduction:
Heartbeat Health is looking for a skilled Credentialing Specialist to join our growing virtual-first cardiovascular care organization. As a Credentialing Specialist, you will play a key role in ensuring our nationwide network of providers is fully credentialed and payer-enrolled across multiple states. This role supports our mission to deliver high-quality, data-driven heart care by maintaining compliance, optimizing revenue cycles, and streamlining provider onboarding in a fast-paced telehealth environment.
Key Responsibilities of a Credentialing Specialist
As a Credentialing Specialist, you will manage the entire provider credentialing and payer enrollment process to ensure accuracy, compliance, and efficiency.
- Manage end-to-end credentialing and payer enrollment for telehealth providers nationwide.
- Submit and track applications for government and commercial payers including Medicare, Medicaid, VA, and Tricare.
- Maintain accurate provider records in credentialing systems such as CAQH and payer portals.
- Verify provider credentials—education, board certification, work history, malpractice records, and references.
- Lead and mentor credentialing staff, providing training and quality oversight.
- Collaborate with revenue cycle management (RCM) teams to minimize denials and optimize reimbursement.
- Prepare credentialing reports and maintain payer rosters for compliance and audit readiness.
- Support provider onboarding by ensuring timely completion of credentialing before patient scheduling.
- Implement process improvements to reduce delays and improve accuracy across systems.
Qualifications for a Credentialing Specialist
To thrive in this Credentialing Specialist role, you should bring deep knowledge of payer enrollment and telehealth credentialing processes.
Required:
- High school diploma or equivalent (Associate’s or Bachelor’s in Healthcare Administration preferred).
- 5–7 years of experience in healthcare credentialing and payer enrollment.
- Strong knowledge of government and commercial payer requirements.
- Familiarity with RCM processes and credentialing’s impact on billing.
- Proficiency in CAQH and other credentialing or payer platforms.
- Excellent communication and organizational skills.
Preferred:
- Experience in telehealth or multi-state provider credentialing.
- Background in cardiovascular or specialty healthcare environments.
Why Work as a Credentialing Specialist at Heartbeat Health
Heartbeat Health is a mission-driven organization revolutionizing virtual cardiovascular care.
- 100% remote, flexible work environment.
- Collaborative, fast-paced, and innovative company culture.
- Opportunity to support a nationwide network of heart specialists.
- Competitive compensation and professional development opportunities.
- Commitment to diversity, equity, and inclusion.
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