Top 15 Credentialing specialist remote Jobs in Silver Spring Md

REMOTE Credentialing Specialist for Legal Appeals & Committee Liaison
Johns Hopkins Medicine —Hanover, MD
- Full-time
- Remote
- Writing skills
- Mid-level
- 3 years
Quick Apply
4h
Executive Staff Assistant
US Veterans' Employment and Training Service —Washington, DC
- $121,785 - $158,322 a year
- Online Application
- Hybrid work
- Background check
- Microsoft Outlook
- Pass drug screening
8h
Administrative Assistant / Billing Specialist (Commercial Insurance & Medicaid Focus)
Evolve: A Behavioral Health Center —Sterling, VA
- $20 - $25 an hour
- Part-time
- Hybrid work
- Background check
- Private practice
- HIPAA
- Flexible schedule
Quick Apply
4h
International Project Coordinator
Smithsonian Institution —Washington, DC
- $57,736 - $75,059 a year
- Online Application
- Hybrid work
- Background check
- Pass drug screening
- Mid-level
- Flexible spending account
- Life insurance
10h
Privacy Program Specialist
Smithsonian Institution —Washington, DC
- $121,785 - $158,322 a year
- Online Application
- Background check
- Writing skills
- Pass drug screening
- Flexible spending account
- Life insurance
1d
Recruitment Specialist (O-5 Billet) Non-Supervisory - External
US Immigration and Customs Enforcement —Washington, DC
- $1 - $150,000 a year
- Online Application
- Hybrid work
- Background check
- Pass drug screening
- Mid-level
9d
International Project Coordinator
US Smithsonian Institution —Washington, DC
- $57,736 - $75,059 a year
- Online Application
- Hybrid work
- Background check
- Pass drug screening
- Research
- Health insurance
- Flexible spending account
8h
Supervisory Management and Program Analyst
US Patent and Trademark Office —Alexandria, VA
- $143,913 - $187,093 a year
- Online Application
- Background check
- Pass drug screening
- Office
7d
Privacy Program Specialist
US Smithsonian Institution —Washington, DC
- $121,785 - $158,322 a year
- Online Application
- Background check
- Writing skills
- Pass drug screening
- Health insurance
- Flexible spending account
1d
Director, Office of Mission Critical Operations
US Environmental Protection Agency —Washington, DC
- $197,201 - $228,000 a year
- Online Application
- Hybrid work
- Background check
- Pass drug screening
- Research
- Paid holidays
- Health insurance
8h
Supervisory Government Information Specialist
US Office of the Secretary —Washington, DC
- $169,279 - $197,200 a year
- Online Application
- Background check
- Pass drug screening
- Office
8h
Deputy to the Chairman & Chief Financial Officer, EM-0501-00 (Public)
US Federal Deposit Insurance Corporation —Washington, DC
- $280,000 - $325,000 a year
- Part-time
- Background check
- Pass drug screening
- Office
- Life insurance
3d
Chief Artificial Intelligence Officer/Chief Science and Technology Advisor
US Offices, Boards and Divisions —Washington, DC
- $151,661 - $228,000 a year
- Online Application
- Background check
- Computer Science
- Pass drug screening
14d

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REMOTE Credentialing Specialist for Legal Appeals & Committee Liaison

Johns Hopkins Medicine -
Hanover, MD

Quick Apply

Job Details

Full-time
4 hours ago

Qualifications

Stakeholder engagement
Confidential information handling
Accreditation standards (regulatory compliance area)
Managed care
Managed care organization experience
Writing skills
Regulatory compliance
Technical Proficiency
Documentation reviews

Full Job Description

Excel. Empower. Advance. Shine. Belong. Explore. Flourish. Champion.

Make It Happen At Hopkins!

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States. JHHP is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP has become a leader in provider-sponsored health plans and is poised for future growth.

The Credentialing Legal Appeals Coordinator is a highly visible role that reports directly to the Credentialing Supervisor. The incumbent is responsible for processing high-risk credentialing files and ensuring accuracy, compliance, and timely completion of all related activities.

Key responsibilities include coordinating meetings with the Chairman of the Special Credentials Review Committee (SCRC), board members, and legal counsel; creating, preparing, and presenting reports to the SCRC; and developing risk assessment packets for review. The role also involves preparing additional reports as needed, scheduling and attending legal meetings and appeal hearings, and creating meeting agendas and minutes.

This position requires the ability to manage a demanding workload while meeting strict deadlines. The ideal candidate will possess exceptional written, verbal, and interpersonal communication skills, with the ability to effectively engage with internal and external stakeholders, including attorneys, medical directors, and healthcare providers.

Strong analytical skills are essential to coordinate information from multiple sources, identify errors, and detect subtle inconsistencies in documentation. This role maintains high visibility across the Health System and plays a critical role in supporting credentialing quality and risk management processes.

Requirements

Experience:

Requires thorough knowledge of provider credentialing principles, methods, and procedures, typically acquired through a minimum of three (3) years of credentialing experience. Demonstrated experience managing the process of challenging rejected healthcare provider applications in a managed care credentialing environment is required, such as a Credentials Verification Organization (CVO), Managed Care Organization (MCO), Health Maintenance Organization (HMO), or hospital-based credentialing setting (MSO).

Education:

Requires a professional level of knowledge in business administration and/or management, generally obtained through at least two years of college coursework or equivalent work-related experience. A Bachelor’s degree is preferred.

Knowledge:

Comprehensive understanding of credentialing policies and procedures, including accreditation standards and regulatory requirements related to managed care.

Skills:

Strong organizational skills with the ability to manage a demanding workload with minimal supervision.
Ability to effectively communicate with internal and external stakeholders regarding the interpretation of policies and procedures and identify potential issues.
Ability to interact professionally with internal and external parties, including legal counsel, regarding sensitive and confidential matters.
Excellent written, verbal, and interpersonal communication skills.
Strong technical proficiency with automated support systems and related technologies.
Strong analytical ability to coordinate information from multiple sources, detect errors and subtle inconsistencies in documentation, and develop reports and supporting materials.

Licensure/Certification:

CPMSM (Certified Professional Medical Services Management) or CPCS (Certified Provider Credentialing Specialist) certification preferred but not required.

Salary Range: Minimum 24.32/hour - Maximum 40.16/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

The Hospital reserves the right to modify employee schedules as needed.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

Quick Apply

Refine Your Search

credentialing specialist remote jobs in silver spring md

REMOTE Credentialing Specialist for Legal Appeals & Committee Liaison

Executive Staff Assistant

Administrative Assistant / Billing Specialist (Commercial Insurance & Medicaid Focus)

International Project Coordinator

Privacy Program Specialist

Recruitment Specialist (O-5 Billet) Non-Supervisory - External

International Project Coordinator

Supervisory Management and Program Analyst

Privacy Program Specialist

Director, Office of Mission Critical Operations

Supervisory Government Information Specialist

Deputy to the Chairman & Chief Financial Officer, EM-0501-00 (Public)

Chief Artificial Intelligence Officer/Chief Science and Technology Advisor

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