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Duration: 5 Months

Job Description:

+ The Credentialing and Provider Enrollment Specialist supports key areas business, quality and compliance support for a clinical Telehealth practice.

+ This is a 100% remote role, requiring 25–30 hours per week.

Responsibilities:

+ Deliver credentialing, privileging, and payer enrollment services for clinical providers.

+ Provide administrative support for provider licensing and CME activities.

+ Support quality programs through clinical audits, compliance tracking, and outcome reporting.

+ Organize, facilitate, and document clinical reporting and review meetings between provider staff and the quality team.

+ Process initial and recredentialing applications in accordance with NCQA, URAC, CMS, and other regulatory standards.

+ Verify provider credentials (licensure, DEA, board certification, liability coverage, etc.) through appropriate primary sources.

+ Manage payer enrollment, revalidations, CAQH profiles, NPPES registrations, and provider data within the credentialing system.

+ Monitor credentialing cycles, license expirations, and sanction alerts.

+ Maintain current knowledge of national credentialing standards and regulations to ensure compliance.

+ Coordinate provider file reviews and clinical encounter audits with internal staff and third-party reviewers.

+ Prepare and deliver monthly and quarterly quality and compliance reports.

Experience (Mandatory):

+ 5 years of progressive experience in credentialing and provider enrollment.

+ Certified Provider Credentialing Specialist (CPCS) preferred.

+ Knowledge of credentialing, privileging, and provider enrollment regulatory standards.

+ Strong understanding of credentialing databases and reporting tools and/or the ability to quickly learn them.

+ Strong sense of ethics and demonstrated integrity in handling confidential information.

+ Detail-oriented, Excellent written, verbal, and interpersonal communication skills.

+ Analytical, problem solving, decision-making and organizational skills.

+ Ability to work independently to accomplish objectives accurately and expeditiously.

Education:

+ Bachelor’s degree or equivalent practical experience.

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.