Credentialing Specialist

Sailor Health

Credentialing Specialist responsible for managing provider enrollment and credentialing at Sailor Health. Engaging with Medicare and enhancing credentialing processes.

Posted 6/24/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $40,000 - $55,000 per yearWebsite

About the role

Key responsibilities & impact

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.

Requirements

What you’ll need

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, stay organized, and meet deadlines in a fast-paced environment.
Experience building SOPs and improving operational workflows.
Able to work cross-functionally and communicate clearly with internal teams and external partners.

Benefits

Comp & perks

Competitive salary
Comprehensive benefits, including medical insurance
Flexible PTO and sick days
Friendliest and most dynamic team culture

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

provider enrollmentcredentialingSOP developmentworkflow optimizationcompliance monitoringattention to detailorganizational skillsdeadline management

Soft Skills

communicationcross-functional collaboration