Credentialing Specialist - Laurel Fork, VA

Location: Laurel Fork

Tri-Area Community Health is seeking a credentialing specialist to join our growing team. This full-time position is at the corporate location in Laurel Fork. The hours are primarily M-F, 8 to 5 with an opportunity for a flexible schedule following complete training. The position begins fully in person with a potential for hybrid work upon adequate evaluation of training.

Position Summary

* This position provides critical support to the Accounts Receivable Manager and Human Resource Department by managing insurance enrollments for facility sites and for healthcare providers. This role serves as the primary liaison between the clinics, pharmacy locations, insurance payers, and credentialing organizations to ensure seamless enrollment and timely resolutions of enrollment-related issues.

Job Requirements:

Required

* High school diploma or equivalent

* Minimum 2 years of experience in medical billing, credentialing, or insurance enrollment

* Knowledge of insurance enrollment processes and requirements

* Strong attention to detail and organizational skills

* Excellent written and verbal communication abilities

* Proficiency in Microsoft Office Suite (Word, Excel, Outlook)

* Ability to handle confidential information with discretion

Preferred

* Associate's degree in healthcare administration or related field

* Experience working in an FQHC or community health center setting

* Familiarity with CAQH Pro View and other credentialing platforms

* Knowledge of Medicare, Medicaid, and commercial payer enrollment portals

* Knowledge of PECOS, INA, NPI, and NCPDP sites

* Understanding of NPI (National Provider Identifier) processes

* Certified Healthcare Access Associate (CHAA) or similar certification

Pay is based on experience and education. Excellent Benefit package.

E/O/E