Credentialing Specialist

We’re Hiring: Credentialing Specialist – U.S. Healthcare

Please send your resume to [email protected] with your cover letter on the body of the email and use "Credentialing Specialist - Your Name" as the subject line.

📍 Location: Colombo, Sri Lanka | Hybrid

🕒 Working Hours: U.S. Central Time (CST)

Simplibill is looking for an experienced Credentialing Specialist to join our healthcare operations team. This role will be responsible for managing provider credentialing and payer enrollment while ensuring applications are accurate, complete, and followed through to completion.

Key Responsibilities

• Manage end-to-end provider credentialing and enrollment with Medicare, Medicaid, and commercial payers.
• Handle provider applications, revalidations, recredentialing, updates, and terminations.
• Track application status and follow up with payers to resolve delays, missing information, and rejections.
• Maintain accurate credentialing trackers and prepare regular status and productivity reports.
• Monitor pending applications and ensure cases are completed within required timelines.
• Work closely with billing and operations teams to prevent enrollment-related denials and payment delays.
• Ensure all credentialing activities follow payer requirements, regulatory guidelines, and internal SOPs.
• Identify process gaps and help improve credentialing workflows, documentation, and team performance.

Requirements

• 3–5 years of experience in U.S. healthcare credentialing and payer enrollment.
• Strong knowledge of Medicare, Medicaid, and commercial payer enrollment processes.
• Hands-on experience with CAQH ProView, NPPES, PECOS, and payer portals .
• Experience with application tracking, reporting, payer follow-ups, and managing multiple cases.
• Strong knowledge of credentialing documentation and requirements.
• Good working knowledge of Microsoft Excel.
• Strong written and verbal communication skills.
• Ability to work independently, manage deadlines, and follow up consistently.

What We Offer

• Competitive salary package.
• Hybrid working environment.
• Opportunity to work with U.S.-based healthcare clients and teams.
• Exposure to healthcare technology and modern credentialing workflows.
• Collaborative, performance-driven work environment.
• Long-term career growth and development opportunities.

About Simplibill

Simplibill is a healthcare technology company helping providers and billing organizations improve their Revenue Cycle Management through technology, automation, and better workflows.

Our platform brings billing operations, reporting, and workflow management together to help healthcare organizations improve efficiency, reduce delays, and gain better visibility into their operations.

Interested?

If you have hands-on U.S. healthcare credentialing experience and are looking for an opportunity to grow with a healthcare technology company, we’d like to hear from you.

Alternatively apply through LinkedIn.