Credentialing Specialist
Sailor Health· Payer
Remote$40k - $55kFull-timePosted 7mo ago
About the role
Remote Credentialing Specialist role focused on end-to-end provider credentialing, primarily with Medicare PECOS, Medicare Advantage plans, and CAQH data management, across the US and Canada.
Responsibilities
- Manage provider enrollment & credentialing: Lead the full credentialing lifecycle for new and existing providers and practice locations — including Medicare (PECOS), Medicare Advantage plans, and other payers.
- Maintain provider data: Ensure CAQH profiles are complete, current, and accurately reflect provider credentials and practice information.
- Optimize workflows: Assess current credentialing processes, identify inefficiencies, and implement improvements using Airtable, automation tools, and best practices.
- Develop SOPs: Write, maintain, and iterate standard operating procedures for credentialing functions and integrate them into operational practice.
- Monitor compliance: Track credentialing status, re-credentialing deadlines, notices, and plan requirements to ensure uninterrupted provider participation in payer networks.
- Communicate across teams: Partner with internal stakeholders — including Clinical Operations, Payer Strategy, and Provider Growth — to align priorities and share updates on credentialing progress and blockers.
- Provider support: Serve as a credentialing point of contact for providers and internal teams, answering questions and coordinating documentation submissions.
Qualifications
- 3+ years of direct experience in provider enrollment and credentialing, including both group and individual provider enrollments.
- Extensive experience working with PECOS enrollments, I&A, and request for corrections – this is a must.
- Prior work with Medicare Advantage health plans and credentialing requirements.
- Comfortable learning and using tools such as Airtable, credentialing automation software, and common office/productivity apps.
- Impeccable attention to detail, organized, and able to meet deadlines in a fast-paced environment.
- Experience building SOPs and improving operational workflows.
- Ability to work cross-functionally and communicate clearly with internal teams and external partners.
Skills
Required:Provider enrollment and credentialingPECOSMedicare Advantage credentialingCAQH data management
Benefits
- Competitive salary
- Comprehensive benefits, including medical insurance
- Flexible PTO and sick days
- Friendly and dynamic team culture
Last updated Jul 15, 2026. Interested? Apply on the company site.
About Sailor Health
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