Benefits:

401(k)

Bonus based on performance

Company parties

Competitive salary

Flexible schedule

Health insurance

Opportunity for advancement

Paid time off

Position Title: Medical Credentialing Specialist

Job Type: Full-Time

Compensation: 55,000-60,000 (based on experience)

Background check will be required

Position Overview

Fisher Health System is seeking a detail-oriented and highly organized Medical Credentialing Specialist to join our growing administrative division. This role is essential in supporting our providers and ensuring seamless operations across our expanding healthcare network. This is a remote position. Candidates must have a dedicated home workspace and are responsible for providing their own reliable computer equipment, and necessary office supplies to effectively perform job duties. The Medical Credentialing Specialist will be responsible for managing the full credentialing lifecycle, including initial credentialing, re-credentialing, payer enrollment, and provider validation with commercial and government insurance carriers. This individual will also support revenue cycle operations by assisting with medical billing tasks such as claim submission through our EMR system, claim appeals, payment posting, and aging report management. This position plays a critical role in maintaining compliance, optimizing reimbursement timelines, and ensuring providers are properly enrolled and credentialed to deliver care without interruption. To support efficient workflows, Fisher Health System utilizes integrated EMR systems and streamlined administrative processes that enhance accuracy, compliance, and communication across departments. At Fisher Health System, we are not simply hiring to fill a position, we are looking for a Medical Credentialing Specialist who values precision, accountability, and teamwork. Our organization prioritizes operational excellence and patient-centered care, ensuring that providers are fully supported so they can focus on delivering high-quality medical services.

Compensation & Benefits

Benefits Include:

401(k) retirement plan

Medical, dental, and vision insurance

Paid time off (PTO)

Paid holidays

Life and disability insurance

Opportunities for professional growth within a growing healthcare organization

Practice & Administrative Model

Multi-specialty medical group

EMR-based billing and claims submission

Collaborative administrative structure

Growing provider network

Focus on compliance, accuracy, and timely reimbursement

Responsibilities

Manage initial credentialing and re-credentialing for providers with commercial and government payers

Maintain CAQH profiles and ensure all provider documentation remains current

Track provider license renewals, DEA registrations, board certifications, and malpractice coverage

Submit and monitor payer enrollment applications

Communicate with insurance carriers regarding application status and discrepancies

Submit medical claims through EMR systems

Review and appeal denied claims

Work aging reports to resolve outstanding balances

Post insurance and patient payments accurately

Maintain credentialing databases and compliance records

Ensure adherence to payer guidelines and regulatory standards

Collaborate with billing, compliance, and provider teams to support revenue cycle integrity

Qualifications

Education & Experience

High school diploma required; Associate’s or Bachelor’s degree preferred

Minimum 5 years of medical credentialing experience preferred

Minimum 5 years of medical billing experience preferred

Experience working with EMR systems

Familiarity with CAQH, PECOS, and payer portals preferred

Skills & Competencies

Strong attention to detail and organizational skills

Knowledge of medical terminology and insurance processes

Ability to manage multiple deadlines and provider files simultaneously

Excellent written and verbal communication skills

Proficiency in Microsoft Office and healthcare software systems

Strong problem-solving abilities and follow-through