Provider Credentialing Specialist

Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. As a Provider Credentialing Specialist, you will support provider clients with payer enrollment, credentialing, and recredentialing activities. You will maintain accurate provider information, track applications and renewals, and help ensure providers remain properly enrolled and eligible to participate with applicable insurance plans.

WHAT YOU WILL DO

• Prepare and submit provider credentialing and payer enrollment applications

• Collect, review, and maintain provider documentation, including licenses, certifications, and professional information

• Verify provider credentials and ensure required documentation remains current

• Track credentialing applications, approvals, expirations, and recredentialing deadlines

• Follow up with insurance payers and credentialing organizations regarding application status

• Maintain accurate provider records in credentialing databases and internal systems

• Identify missing or inconsistent information and work with provider teams to resolve documentation issues

• Support updates to provider information, including practice locations, specialties, and payer participation

• Maintain organized documentation and follow established privacy and compliance procedures

WHAT WE ARE LOOKING FOR

• 1+ year of experience in provider credentialing, payer enrollment, medical administration, or a related healthcare role

• Understanding of provider credentialing and payer enrollment processes

• Experience working with insurance payers, credentialing organizations, or provider networks

• Strong attention to detail and ability to manage multiple applications, deadlines, and follow-ups

• Experience reviewing and maintaining professional licenses, certifications, and provider documentation

• Strong organizational and time-management skills

• Ability to communicate effectively with providers, payer representatives, and internal teams

• Ability to work independently and effectively in a fully remote environment

• HIPAA-compliant private workspace

NICE TO HAVE

• Experience with CAQH and other provider credentialing or enrollment platforms

• Experience with Medicare, Medicaid, or commercial payer enrollment

• Knowledge of NPI, taxonomy codes, and provider enrollment requirements

• Experience with hospital or multi-specialty provider credentialing

• Familiarity with Epic, Athena, eClinicalWorks, or other healthcare systems