Credentialing Specialist

Heartbeat Health

Credentialing Specialist handling end-to-end provider credentialing and payer enrollment for telehealth at Heartbeat Health. Ensuring compliance and optimizing turnaround times for virtual care.

Posted 7/13/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider credentialing and payer enrollment processes, ensuring compliance and accuracy across multi-state telehealth operations. Proficient in managing credentialing systems and optimizing revenue cycle management through effective oversight and training.

Highest-signal resume keywords

Healthcare CredentialingPayer EnrollmentRevenue Cycle Management (RCM)Credentialing PlatformsGovernment Payer Regulations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider CredentialingPayer EnrollmentCredentialing ComplianceData Integrity ManagementApplication Tracking

Soft Skills

Organizational SkillsAttention to DetailMentoringTrainingQuality Assurance

Tools & Technologies

CAQHPayer PortalsCredentialing Systems

Industry Keywords

TelehealthMulti-State CredentialingGovernment PayersCommercial PayersHealthcare Administration

About the role

Key responsibilities & impact

This role is responsible for end-to-end provider credentialing and payer enrollment across government and commercial payers, ensuring providers are set up for success in a multi-state, virtual care environment.
Complete and manage all aspects of initial credentialing, re-credentialing, and payer enrollment for a large network of telehealth providers across the U.S.
Submit and track applications with government payers (Medicare, Medicaid, VA, Tricare) and commercial/private payers to ensure active participation status.
Lead and mentor credentialing staff, providing training, guidance, and quality checks.
Serve as the subject matter expert (SME) for credentialing, payer enrollment, and their connection to revenue cycle processes
Optimize credentialing turnaround time and reduce payer enrollment delays that impact revenue
Stay up to date on payer regulations and credentialing requirements across all states where the organization provides telehealth services
Analyze denial trends related to credentialing/enrollment issues and implement corrective actions
Track payer roster accuracy and manage data integrity between credentialing systems and billing systems.
Maintain accurate provider records in credentialing systems (e.g., CAQH, payer portals, internal databases), ensuring information is current and compliant.
Verify provider credentials including education, training, board certification, work history, malpractice history, and references.
Ensure provider enrollment aligns with billing requirements, reducing claim denials and reimbursement delays for a streamlined Revenue Cycle Management (RCM) process
Monitor payer rosters and enrollment timelines to proactively resolve issues that may impact revenue.
Support the onboarding of new providers by ensuring credentialing and enrollment are completed prior to patient scheduling.
Prepare reports on credentialing status, payer enrollment progress, and upcoming expirations for leadership and compliance purposes.
Assist with audits, quality checks, and process improvements to ensure compliance.

Requirements

What you’ll need

High school diploma or equivalent required; Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred.
5-7 years of experience in healthcare credentialing and payer enrollment (telehealth or multi-state experience strongly preferred).
Strong knowledge of government and commercial payer enrollment requirements
Familiarity with RCM processes and how credentialing impacts reimbursement
Proficiency with credentialing platforms and payer portals (e.g., CAQH)
Excellent organizational skills with the ability to manage multiple providers and payers across states
High attention to detail, accuracy, and ability to meet strict deadlines

Benefits

Comp & perks

We are mission-driven: we're revolutionizing the way cardiovascular care is delivered
We are fast-paced & agile: we move quickly, iterate often, and value experimentation
We are remote-first: flexibility, autonomy, and trust are at the core of how we operate
We care about diversity: diversity allows us to build an excellent patient experience
We are an equal opportunity employer: we do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status