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Healthcare Insurance Payor Contracts & Credentialing Specialist

Pharmacare

Pharmacare Hawaii is seeking a Healthcare Insurance Payor Contracts & Credentialing Specialist to oversee payor contract data, streamline provider enrollment, and maintain regulatory compliance across health plans. This role serves as a key link between contracting, credentialing, billing, and operational teams to help ensure smooth revenue cycle management, prevent reimbursement disruptions, and maintain accurate provider directory information.

The position is based in Honolulu and follows a Monday through Friday, 8:30 am to 5:00 pm schedule.

Requirements & Qualifications

Minimum Qualifications

  • 2+ years of hands-on experience in healthcare payor contracting, provider enrollment, or credentialing
  • Direct experience with CAQH ProView, PECOS, NPPES, and electronic credentialing management software
  • Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and Teams
  • Ability to pass a background check and drug screen

Preferred Qualifications

  • Associate or bachelor's degree in Healthcare Administration, Business, or a related field preferred; equivalent practical experience considered
  • CPCS or Certified Provider Credentialing Specialist credential preferred
  • Familiarity with AI-assisted credentialing tools, automated license-monitoring platforms, and practice management/EHR platforms
  • Strong attention to detail, data management skills, and professional communication abilities
  • Good verbal and written communication skills
Benefits & Perks

Benefits

  • 401(k)
  • Dental insurance
  • Health insurance
  • Paid time off
  • Vision insurance

Location

Honolulu, Hawaii, US

Employment Type

Full-time

Experience Level

Associate

Remote work allowed

No

Posted

3 weeks ago

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