Medical Credentialing Specialist

About the role

AMS Solutions, a medical billing and revenue cycle management company serving healthcare practices across the United States, is hiring an experienced Medical Credentialing Specialist. The role supports the end-to-end credentialing and re-credentialing of healthcare providers across multiple U.S. states, keeping them enrolled with insurance payers so they receive timely and accurate reimbursement. The position is remote, open to one person, and requires availability during U.S. business hours (Eastern or Central time).

Key responsibilities

• Manage initial and re-credentialing applications for physicians and mid-level providers across several U.S. states.
• Maintain accurate, current CAQH ProView profiles and attestation-ready provider data.
• Submit and track payer enrollment applications with commercial insurers, Medicare and Medicaid, and monitor timelines and escalations.
• Keep organized credentialing files (licenses, DEA certificates, malpractice insurance, board certifications) and coordinate with providers and practice managers.
• Track license and certification expirations and initiate renewals proactively.
• Resolve payer enrollment issues, denials and discrepancies, and prepare roster adds/changes for group enrollments.
• Generate regular status reports on credentialing activity and turnaround times.

Required profile

• 2-5 years of hands-on medical credentialing and payer enrollment experience.
• Demonstrated multi-state credentialing experience (enrollment in 3+ U.S. states).
• Familiarity with commercial payer enrollment (UnitedHealthcare, Aetna, Cigna, Blue Cross Blue Shield, Humana, etc.), Medicare and Medicaid enrollment.
• Strong written and verbal English, attention to detail, and ability to handle multiple provider files and deadlines.
• Reliable internet connection and dedicated home office setup for remote work.

Required skills

• CAQH ProView, PECOS and NPPES/NPI systems.
• Credentialing software and practice management systems.
• Preferred: CPCS or CPMSM certification, experience with eClinicalWorks, Athena or AdvancedMD, and knowledge of provider contracting and fee schedules.