Provider Credentialing Specialist

Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. As a Provider Credentialing Specialist, you will support provider clients with payer enrollment, credentialing, and recredentialing activities. You will maintain accurate provider information, track applications and renewals, and help ensure providers remain properly enrolled and eligible to participate with applicable insurance plans.
WHAT YOU WILL DO

Prepare and submit provider credentialing and payer enrollment applications

Collect, review, and maintain provider documentation, including licenses, certifications, and professional information

Verify provider credentials and ensure required documentation remains current

Track credentialing applications, approvals, expirations, and recredentialing deadlines

Follow up with insurance payers and credentialing organizations regarding application status

Maintain accurate provider records in credentialing databases and internal systems

Identify missing or inconsistent information and work with provider teams to resolve documentation issues

Support updates to provider information, including practice locations, specialties, and payer participation

Maintain organized documentation and follow established privacy and compliance procedures

WHAT WE ARE LOOKING FOR

1+ year of experience in provider credentialing, payer enrollment, medical administration, or a related healthcare role

Understanding of provider credentialing and payer enrollment processes

Experience working with insurance payers, credentialing organizations, or provider networks

Strong attention to detail and ability to manage multiple applications, deadlines, and follow-ups

Experience reviewing and maintaining professional licenses, certifications, and provider documentation

Strong organizational and time-management skills

Ability to communicate effectively with providers, payer representatives, and internal teams

Ability to work independently and effectively in a fully remote environment

HIPAA-compliant private workspace

NICE TO HAVE

Experience with CAQH and other provider credentialing or enrollment platforms

Experience with Medicare, Medicaid, or commercial payer enrollment

Knowledge of NPI, taxonomy codes, and provider enrollment requirements

Experience with hospital or multi-specialty provider credentialing

Familiarity with Epic, Athena, eClinicalWorks, or other healthcare systems

COMPENSATION AND BENEFITS
Compensation will be discussed during the interview and will reflect the candidate’s experience, qualifications, and relevant healthcare administration expertise.
Benefits and additional employment details will be discussed during the hiring process.
HIRING PROCESS
Application review → introductory conversation → hiring manager interview → offer.
EQUAL OPPORTUNITY
Raventra Health is an equal opportunity employer. We consider all qualified applicants without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. If you need an accommodation at any stage of the hiring process, please contact us and we will work with you to provide appropriate support.
Location: Remote
Originally posted on Himalayas