Credentialing Specialist (CAQH, Medicaid, TRICARE)
Get providers enrolled and keep them enrolled. An unenrolled provider cannot bill, so this seat protects revenue before it exists.
The role
What this job actually is
You run provider enrollment and re-credentialing across commercial payers, Medicaid and TRICARE. You own applications end to end, keep CAQH and PECOS current, and track every expirable so nothing lapses. Credentialing delays are unbillable capacity, so speed and accuracy here are directly financial.
Ownership
What you will own
Enrollment applications
Prepare and submit complete applications the first time. Incomplete submissions are the main cause of delay.
CAQH and PECOS currency
Keep profiles attested, complete and current.
Expirables tracking
Licenses, DEA, malpractice, board certifications. Nothing expires unnoticed.
Payer follow-up
Chase pending applications on a documented cadence until an effective date is issued.
Re-credentialing
Start re-credentialing well ahead of the deadline.
Status reporting
Maintain an accurate provider-by-payer status view.
Ramp
Your first 90 days
First 30 days
Learn client rosters and payer requirements, then baseline pending applications and expirable risk.
By day 60
Follow-up cadence running, expirable calendar current, aged applications escalated.
By day 90
Predictable enrollment turnaround and zero surprise expirations.
Requirements
What we look for
- Two or more years in US provider credentialing and payer enrollment
- Hands-on with CAQH, PECOS and commercial payer portals
- Medicaid and TRICARE enrollment experience
- Meticulous document and deadline discipline
- Comfortable following up persistently with payers
Bonus
Strong plus, not required
- Behavioral health or ABA provider enrollment
- Multi-state enrollment experience
- Experience with credentialing software
Accountability
How this role is measured
| Measure | What it means |
|---|---|
| Enrollment turnaround | Submission to effective date. |
| First-pass application acceptance | Submitted complete. |
| Expirable lapses | Target is zero. |
| Re-credentialing timeliness | Started before deadline. |
| Roster accuracy | Status view current. |
| Follow-up cadence | Adherence to schedule. |
Why ASP-RCM
Why this seat is different
We are senior-led by design. A senior partner is named on accounts and shows up in the work, which is why clients renew and why this role carries real authority rather than a title. Our AI suite is in production, not in a roadmap deck, and our compliance posture is independently audited: SOC 2 Type II with HITRUST, ISO 27001 and HIPAA.
We pay for certifications and run upskilling cohorts, because coding and revenue cycle are crafts that need investment. You will work across Dallas HQ, six US states and Chennai, India, with colleagues who have run these functions at scale.