The Credentialing Specialist manages provider onboarding, enrollment, and maintenance activities to ensure compliance with payer and regulatory requirements. They serve as a key coordinator between providers, payers, and internal departments while maintaining accurate provider records.
The Claims Specialist is responsible for managing and resolving outstanding insurance and patient accounts to ensure timely reimbursement. This role involves analyzing denied claims, submitting appeals, and collaborating with internal teams to improve revenue cycle performance.
