Credentialing and Coding Specialist bei undefined

About First Medical Associates

First Medical Associates is a leading, technology-driven primary care organization serving patients across Maryland. Our mission is to make healthcare smarter, faster, and more human — powered by great people and cutting-edge technology.

We are seeking a Credentialing & Coding Specialist to join our growing administrative team. The ideal candidate will combine strong organizational skills with a comfort for digital tools and AI-enabled workflows to help streamline provider onboarding, payer enrollment, and coding accuracy.

Position Summary

This role supports the full lifecycle of provider credentialing, payer enrollment, and coding operations. The Credentialing & Coding Specialist ensures that all provider data and payer relationships are accurate, current, and seamlessly integrated with our billing systems to support timely reimbursements and compliance.

You’ll work closely with our Revenue Cycle, Clinical, and Operations teams to keep our systems optimized, reduce delays, and enhance the financial health of our growing organization.

Key Responsibilities

• Manage provider credentialing, enrollment, and revalidation across Medicare, Medicaid, and commercial payers (including PECOS, CareFirst, and CAQH).

• Accurately maintain provider data, licenses, NPI, and demographic information in internal systems and payer portals with a two-day turnaround goal.

• Use digital dashboards and AI-assisted tools to track application status, automate reminders, and identify bottlenecks.

• Collaborate with billing and RCM teams to ensure payer approvals are reflected in billing systems immediately to avoid claim denials or delays.

• Review clinical documentation and apply appropriate ICD-10, CPT, and HCPCS coding to ensure accuracy and compliance.

• Work closely with providers to resolve missing or inconsistent data through clear email and phone communication.

• Maintain strict adherence to HIPAA, CMS, and accreditation requirements.

• Generate reports and metrics on credentialing progress, coding accuracy, and turnaround times.

Required Skills & Experience

• Minimum 2 years of experience in healthcare credentialing, coding, or payer enrollment.

• Strong attention to detail and data accuracy under fast-paced conditions.

• Proficiency in Google Workspace, Microsoft Office Suite, and Athenahealth (preferred).

• Working knowledge of ICD-10, CPT, HCPCS, and insurance documentation requirements.

• Familiarity with PECOS, CAQH, and commercial payer portals.

• Ability to manage multiple priorities, communicate clearly, and collaborate effectively with physicians and administrative staff.

Preferred Qualifications

• Bachelor’s degree in Healthcare Administration, Business, or related field.

• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Coder (CPC) credential.

• Experience using AI-based credentialing or coding platforms.

• 3+ years of experience in provider credentialing or medical billing operations.

Why Join First Medical Associates

• Work with a tech-forward, AI-enhanced medical group that values efficiency, innovation, and professional growth.

• Collaborative team culture with open communication and ongoing learning opportunities.

• Competitive compensation, benefits, and a supportive environment where your contributions directly impact patient care and practice success.

First Medical Associates is an Equal Opportunity Employer. 

Experience Requirements

• HCPCS: 3 years (Required)

• Medicare (PECOS): 3 years (Preferred)

• CAQH: 2 years (Preferred)

• Medical Coding Certification: Preferred