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Provider Credentialing & A/R Specialist

CoreLife Healthcare
$42,634 - $50,054 a year
Anne Arundel County, Maryland
Full time
1 day ago

?? Now Hiring: Provider Credentialing & Accounts Receivable Specialist
Location: Linthicum, MD
Reports To: Vice President, RCM Operations
Employment Type: Full-Time

CoreLife is seeking a detail-oriented and highly motivated Provider Credentialing & Accounts Receivable Specialist to join our team. This dual-function role is critical in ensuring accurate provider enrollment, maintaining credentialing compliance, and supporting revenue cycle operations. If you have a strong background in medical credentialing, payer enrollment, and A/R management?and enjoy working in a fast-paced, mission-driven environment?we?d love to hear from you!

?? Key Responsibilities

Credentialing & Enrollment:

  • Prepare and submit provider enrollment applications and supporting documentation across multiple payers.

  • Maintain accurate and compliant records for licenses, certifications, and insurance contracts.

  • Track and process new enrollments, revalidations, ERN/ERA submissions, and roster updates.

  • Coordinate with HR, providers, and billing teams to streamline onboarding and credentialing processes.

  • Manage CAQH profiles and update PECOS and NPPES as needed.

  • Maintain HIPAA-compliant credentialing files and communication with payer credentialing teams.

Accounts Receivable Management:

  • Review and manage aging A/R > 30 days, ensuring timely follow-up and maximum reimbursement.

  • Address denied claims, rework errors, file appeals, and communicate with payers as needed.

  • Monitor payer reimbursements against contracted rates.

  • Provide coverage and support across the team during absences or high-volume periods.

  • Work within EPIC and NextGen systems, and utilize EMR tools for charge entry and collections tracking.

?? Qualifications

Required:

  • High school diploma or equivalent.

  • Minimum 3 years of experience in provider credentialing and/or medical billing.

  • Experience with PECOS and ePREP.

  • Knowledge of payer requirements and CPT/ICD-10 coding.

Preferred:

  • Associate or Bachelor?s degree in healthcare, business, or related field.

  • 5+ years of experience in credentialing and A/R management.

  • Experience with EPIC and NextGen.

  • Familiarity with NCQA standards and processes.

?? Skills & Abilities

  • Exceptional attention to detail and organizational skills.

  • Ability to multitask, prioritize, and work independently.

  • Strong problem-solving and critical thinking capabilities.

  • Excellent communication and interpersonal skills.

  • Proficiency with Microsoft Excel and payer web portals.

  • Commitment to confidentiality and HIPAA compliance.

?? Why CoreLife?

At CoreLife, we are committed to delivering exceptional patient outcomes and creating a supportive, respectful environment for our team. You?ll be part of an innovative, growing company dedicated to transforming healthcare through integrated, whole-person care.

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