Top 2 Credentialing specialist Jobs in Honolulu, Hi

Healthcare Insurance Payor Contracts & Credentialing Specialist
Pharmacare —Honolulu, HI
- $30 - $35 an hour
- Full-time
- Background check
- Microsoft Outlook
- Pass drug screening
- Health insurance
- Dental insurance
Quick Apply
7d
Medical Staff Peer Review and Performance Improvement Specialist (Full-Time, 40, Day Shift)
The Queens Health Systems —Honolulu, HI
- $65,722 - $80,510 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
13d

Discover related jobs

Based on your search for credentialing specialist jobs.

Healthcare Insurance Payor Contracts & Credentialing Specialist
Pharmacare —Honolulu, HI
*Technical Tools:* Familiarity with AI-assisted credentialing tools, automated license-monitoring platforms, and practice management/EHR platforms.
$30 - $35 an hour
Quick Apply
7d

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Credentialing Specialist
Integrated Services for Behavioral Health —Columbus, OH
A valid driver's license and the ability to operate a motor vehicle is required. A bachelor’s degree in accounting, credentialing, or a related field is…
$23.85 - $28.02 an hour
Quick Apply
7d
Credentialing Specialist-(Day)FT
Adena Health System —Chillicothe, OH
Must possess a valid National Association Medical Staff Services (NAMSS) Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified…

Show more jobs in cities nearby

I want to receive the latest job alert for credentialing specialist in honolulu, hi

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

credentialing specialist jobs near honolulu, hi

Credentialing Specialist jobs in Honolulu, HI

Performance Improvement Specialist jobs in Sleepy Hollow, NY

Inventory Specialist jobs in Remote

Peer Support Specialist jobs in Washington State

Performance Improvement Specialist jobs in Delray Beach, FL

Performance Improvement Specialist jobs in Oakland, CA

Child Development Specialist jobs in San Diego, CA

Performance Improvement Specialist jobs in Fort Myers, FL

Human Resources Specialist jobs in Honolulu, HI

Credentialing Specialist jobs in Atlanta, GA

Credentialing Specialist jobs in Knoxville, TN

Credentialing Specialist jobs in Florida

Marketing Specialist jobs in Los Angeles, CA

Credentialing Specialist jobs in Illinois

Credentialing Specialist jobs in Scottsdale, AZ

Healthcare Insurance Payor Contracts & Credentialing Specialist

Pharmacare -
Honolulu, HI

Quick Apply

Job Details

Full-time
$30 - $35 an hour
7 days ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Teamwork
Microsoft Outlook
Interpersonal skills
Certified Provider Credentialing Specialist
Data management
Attention to detail
Microsoft Teams
Technical Proficiency

Full Job Description

About Pharmacare:

Care Done Right For over 90 years, Pharmacare Hawaii has been providing care to its patients with the same Aloha Spirit as they did for generations. Today this third generation locally owned and operated pharmacy employs nearly 200 employees over its locations on Oahu, Maui, Kauai and Hilo. Be part of the team that is committed to helping improve the health of our community. 2025 Hawaii Business Magazine Top 250 Company

Job Summary:

The Healthcare Insurance Payor Contracts & Credentialing Specialist is responsible for overseeing payor contract data, streamlining provider enrollment, and maintaining regulatory compliance across all health plans. This position acts as a critical link between contracting, credentialing, billing, and operational teams to ensure seamless revenue cycle management, prevent reimbursement disruptions, and ensure provider directory accuracy.

Key Responsibilities:

Provider Enrollment & Credentialing Operations

Execute end-to-end provider enrollment, primary source verification, and re-credentialing with commercial, Medicare, Medicaid, and managed care payors.
Maintain accurate records in provider enrollment databases (e.g., CAQH, NPPES, PECOS) and state licensing boards.
Prepare and support delegated credentialing audits, payor directory reviews, and roster submissions.

Contract Analysis & Data Integrity

Maintain internal contract management systems, fee schedules, payor lines of business (LOB), and fee schedule effective dates.
Audit and reconcile payor directory listings regularly to ensure strict compliance with contractual and regulatory standards.
Track contract amendments, rate changes, and expiration dates to ensure timely renewals and updates.

Revenue Cycle & Issue Resolution

Investigate and resolve credentialing- or contract-related claim denials and billing holds in collaboration with billing and receivables teams.
Identify root causes of payor enrollment bottlenecks and implement workflow improvements to reduce time-to-in-network status.
Serve as a subject matter expert and key liaison for payor representatives regarding enrollment status, contracting updates, and demographic changes.

Schedule: Monday through Friday, 8:30 am - 5:00 pm

This position is in-person at our office in Honolulu.

Minimum Qualifications:

Experience: 2+ years of hands-on experience in healthcare payor contracting, provider enrollment, or credentialing.
Systems Proficiency: Direct experience with CAQH ProView, PECOS, NPPES, and electronic credentialing management software.
Knowledgeable of MS Office applications including Word, Excel, Outlook, Teams, etc.
MUST be able to pass a background check and drug screen

Preferred Qualifications

Education: Associate or Bachelor’s degree in Healthcare Administration, Business, or related field preferred (equivalent practical experience considered).
Certifications: Certified Professional Credentialing Specialist (CPCS) or Certified Provider Credentialing Specialist credential a strong plus.
Technical Tools: Familiarity with AI-assisted credentialing tools, automated license-monitoring platforms, and practice management/EHR platforms.
Core Competencies: Exceptional attention to detail, strong data management skills, and clear professional communication.
Good verbal and written communication skills

Job Type: Full-time

Pay: $30.00 - $35.00 per hour

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance

Application Question(s):

Are you able to pass a background check and drug screen?

Experience:

hands-on healthcare payor contracting: 2 years (Required)
hands-on provider enrollment: 2 years (Required)
hands-on credentialing: 2 years (Required)
electronic credentialing management software: 2 years (Required)

Ability to Commute:

Honolulu, HI 96819 (Required)

Work Location: In person

Quick Apply

Refine Your Search

credentialing specialist jobs in honolulu, hi

Healthcare Insurance Payor Contracts & Credentialing Specialist

Medical Staff Peer Review and Performance Improvement Specialist (Full-Time, 40, Day Shift)

Discover related jobs

Explore jobs in cities nearby

I want to receive the latest job alert for credentialing specialist in honolulu, hi

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected