Provider Credentialing & Accounts Receivable Specialist

Job Description

Job Description

📢 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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