Job Title: Credentialing Specialist / Medical Auditor (RN preferred)
Location: Las Vegas, NV — or fully remote
Schedule: Monday–Friday, 8:00 AM – 4:30 PM (training hours may vary until proficiency is reached)
Responsibilities:
Credentialing applications: Submission of initial and re‑credentialing applications to contracted payers.Licensure maintenance: Track renewals and ensure compliance with state and board requirements.CAQH updates and NPPES enrollment.Roster delegation review: Perform quality checks and maintain accurate records.Data entry: Input and manage information in Symplr Payer.Primary source verification: Validate credentials with boards and licensure authorities.Compliance: Follow NCQA, CMS, AAAHC, URAC, and JC guidelines.Enrollment: Handle commercial and government payer enrollments.Hospital privileges: Manage and understand hospital privilege re...