Credentialing Specialist - Remote
QualDerm Partners
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Job Overview
Location
Remote
Salary
USD 48,152 - 64,917 yearly
Employment Type
Full-time
Work Arrangement
Remote
Sector
Healthcare & Medical
Experience Level
Mid-level (3-5 years)
About the Company
QualDerm Partners stands as a leading force in the dermatology sector, distinguished as the largest female-founded and owned dermatology network in the U.S. With an expansive presence across 17 states and over 150 locations, the company is dedicated to advancing skin health through education, protection, and comprehensive care.
Their mission centers on empowering communities and healthcare professionals with knowledge about skin health, including crucial aspects like skin cancer prevention, risk factors, and the benefits of regular skin examinations. QualDerm Partners is committed to delivering cutting-edge dermatologic care, making high-quality services more accessible while fostering a rewarding work environment for its employees.
The organization emphasizes a patient-centric approach, ensuring that both patients and the professionals who care for them receive exceptional support and resources. This commitment to excellence and growth positions QualDerm Partners as a significant player in the healthcare industry.
Job Description
Join QualDerm Partners, a leading dermatology network, as a remote Credentialing Specialist. This role is crucial for managing the credentialing, re-credentialing, payer enrollment, and privileging processes for providers across assigned regions.
You will collaborate closely with regional operational leaders to ensure all credentialing requirements are met proactively, guaranteeing that providers are ready to offer services under contracted health plans. This position involves implementing standardized processes and meticulously capturing provider data in credentialing databases and online systems.
If you are a detail-oriented professional with a strong understanding of healthcare regulations and a commitment to operational excellence, we encourage you to apply.
To apply for this role, click the Apply button on this page and follow the instructions.
Required Skills
Key Responsibilities
- Oversee all aspects of Provider Credentialing and Payer Enrollment with third party payers and hospital / health system partners for assigned region.
- Assure compliance with all health plan requirements as related to provider certification and credentialing.
- Meets with assigned region operational leadership on a routine basis to ensure timely on-boarding of new providers and that all credentialing needs are met.
- Manages processes that maintain up-to-date data for each provider in credentialing databases and online systems.
- Ensures timely renewal of licenses, certifications, and credentialing.
- Maintains confidentiality of provider information.
- Assist in managing the flow of information between payers, contracted PHO’s, ACO’s and other QualDerm networks.
- Coordinate and prepare management reports for assigned regions.
- Manage continual process and quality improvement efforts related to payer enrollment, data entry, credentialing committees and all aspects related to credentialing & enrollment.
- Participates in the training of new Credentialing & Enrollment team members.
Qualifications
- Bachelor’s degree in related field preferred.
- Minimum of three (3) years’ experience in managed care credentialing or medical staff service setting required.
- National or multi-state credentialing experience preferred.
- Demonstrated skills in analysis, problem solving and resolution.
- Ability to communicate appropriately and effectively with practitioners and providers, including sensitive and confidential information.
- Strong knowledge of NCQA, Joint Commission, URAC, CMS and State Laws and regulations as they pertain to the credentialing of QualDerm providers.
- Prioritize and meet deadlines on an ongoing basis to ensure timely completion according to process requirements.
- Must be able to function independently in a matrix environment.
Benefits & Perks
- Competitive Pay
- Comprehensive Health Coverage (Medical, Dental, Vision)
- Generous 401(k) Plan with immediate vesting
- Paid Time Off (PTO)
- 6 paid holidays and 2 floating holidays
- Company-Paid Life Insurance
- Short-term and long-term disability coverage
- Additional Wellness Plans (Accident, critical illness, identity theft)
- Employee Assistance Program (EAP)
- Exclusive Employee Discounts
- Referral Bonus Program
How to Apply
This job has expired
Join Our Communities
The healthcare industry in the United States is experiencing significant growth, driven by an aging population and advancements in medical technology. This role is pivotal in ensuring seamless provider operations within this dynamic landscape. Key technical skills include NCQA, Joint Commission, URAC, CMS compliance, and payer enrollment systems. The Credentialing Specialist's impact on revenue cycle management and operational efficiency directly influences the organization's financial health and ability to serve a growing patient base, signaling a mid-level to senior impact on business ROI.
Posted Date
May 28, 2026
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