Healthcare Credentialing & QA Specialist (Home Health)

Overview:

Our client is looking for a Healthcare Credentialing & QA Specialist (Home Health) to join their dynamic home health agency. In this role, you will begin with credentialing tasks to enroll the company with multiple insurance payers, then transition into ongoing quality assurance work reviewing clinical documentation, managing corrections, and coordinating with nursing staff. This is a long-term opportunity where you will play a critical role in expanding the company's network and maintaining clinical documentation standards that directly impact patient care and reimbursement.

Schedule: Monday to Friday, 8:30 AM - 5:30 PM Central Time

Responsibilities:

• Complete credentialing paperwork and applications for multiple insurance payers and networks
• Conduct insurance payer research and support network expansion initiatives
• Manage Medicare, Medicaid, and government program enrollment processes
• Handle commercial insurance contracting support and documentation
• Review clinical notes and documentation from nurses and clinicians for quality assurance
• Process corrections sent by the external QA company and implement necessary fixes
• Coordinate with nursing staff to ensure clinical corrections are completed accurately
• Follow up on credentialing applications and resolve any issues that arise
• Maintain organized credentialing records and documentation files
• Provide ongoing support for both credentialing and quality assurance functions

Must-Have Requirements:

• Proven experience in healthcare credentialing processes and payer enrollment
• Strong background in home health operations and documentation standards
• Knowledge of Medicare, Medicaid, and commercial insurance credentialing requirements
• Experience with clinical documentation review and quality assurance processes
• Ability to communicate effectively with clinical staff about documentation corrections
• Strong organizational skills and attention to detail with paperwork management
• Excellent communication skills in English, both written and verbal
• Self-directed work style with ability to manage tasks independently

Nice-to-Have Requirements:

• Nursing or clinical background that assists in understanding medical documentation
• Experience working with external QA companies
• Bonus if you speak South Indian languages
• Experience managing credentialing for multiple healthcare entities simultaneously

Why Join This Team

• Long-term, stable position with a growing home health agency
• Opportunity to work in two critical areas: credentialing and quality assurance
• Remote work flexibility while supporting essential healthcare operations
• Be part of a company actively expanding its network and service capabilities
• Work directly with leadership in a newly acquired business with growth potential
• Contribute to patient care quality through your credentialing and QA work

Independent Contractor Perks:

• Permanent work from home
• Immediate hiring
• Health Insurance Coverage

Note:

Please click the Apply button to complete your application, including the assessment questions, technical check, and voice recording. Your hourly pay rate will be established based on your performance in the application process; submissions with all requirements fulfilled will receive priority review.

One application, multiple possibilities: When you apply, our team reviews your background against all current openings, not just this one! If a different role fits your skills, we'll get in touch! We also encourage you to keep exploring our job board and apply directly to any position that excites you.