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Remote Credentialing Specialist Jobs in Rio Rancho, NM

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Remote Credentialing Specialist information

See Rio Rancho, NM salary details

$12

$22

$36

How much do remote credentialing specialist jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for remote credentialing specialist in Rio Rancho, NM is $22.91, according to ZipRecruiter salary data. Most workers in this role earn between $18.08 and $26.01 per hour, depending on experience, location, and employer.

What are some common challenges faced by remote Credentialing Specialists and how can they be addressed?

Remote Credentialing Specialists often encounter challenges such as coordinating with multiple departments, managing large volumes of documentation, and ensuring compliance with ever-changing regulations. Effective communication skills and strong organizational abilities are essential for staying on top of tasks and deadlines, especially when working remotely. Utilizing secure credentialing software and establishing clear processes for document sharing can help maintain accuracy and streamline collaboration with healthcare providers, HR teams, and regulatory agencies.

What are the key skills and qualifications needed to thrive as a Remote Credentialing Specialist, and why are they important?

To thrive as a Remote Credentialing Specialist, you need a strong understanding of healthcare credentialing processes, attention to detail, and typically a background in healthcare administration or a related field. Familiarity with credentialing software, databases, and knowledge of industry standards such as NCQA or Joint Commission requirements are essential. Excellent organizational skills, clear communication, and the ability to work independently are crucial soft skills for remote success. These skills ensure accurate, timely credentialing of providers, compliance with regulations, and smooth healthcare operations.

What Does a Remote Credentialing Specialist Do?

Remote credentialing specialists have the same job duties as in-house credentialing specialists; the main difference is they work from home or another location outside of the office. As a remote credentialing specialist, you verify the qualifications of the staff in healthcare organizations; you review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures. This verification process ensures that doctors and other medical professionals provide their accurate education and work histories, and confirms that they meet all local and federal licensing and regulation requirements. Remote credentialing specialists also update medical databases with information about a physician’s training or license and document when credentials must be renewed.

What is the difference between Remote Credentialing Specialist vs Remote Medical Biller?

AspectRemote Credentialing SpecialistRemote Medical Biller
Required credentialsHealthcare certifications, licensing knowledgeBilling and coding certifications (e.g., CPC, CCS)
Work environmentHealthcare facilities, insurance companies, remoteMedical offices, billing companies, remote
Employer industry usageHospitals, clinics, healthcare networksMedical practices, billing services
Common search intentCredentialing process, provider enrollmentBilling procedures, insurance claims

The Remote Credentialing Specialist focuses on verifying healthcare providers' credentials and ensuring compliance, while the Remote Medical Biller handles billing, coding, and insurance claims. Both roles often work remotely within the healthcare industry and require specialized certifications. Understanding these differences helps job seekers find the right position aligned with their skills and career goals.

What does a Remote Credentialing Specialist do?

A Remote Credentialing Specialist is responsible for verifying and maintaining the credentials of healthcare professionals to ensure they meet regulatory and organizational standards. Working remotely, they review and process applications, check licenses, certifications, and backgrounds, and work with medical staff to resolve any credentialing issues. This role is essential in healthcare organizations to ensure compliance and patient safety while enabling providers to practice legally and efficiently.
More about Remote Credentialing Specialist jobs
What are popular job titles related to Remote Credentialing Specialist jobs in Rio Rancho, NM? For Remote Credentialing Specialist jobs in Rio Rancho, NM, the most frequently searched job titles are:
What job categories do people searching Remote Credentialing Specialist jobs in Rio Rancho, NM look for? The top searched job categories for Remote Credentialing Specialist jobs in Rio Rancho, NM are:
What cities near Rio Rancho, NM are hiring for Remote Credentialing Specialist jobs? Cities near Rio Rancho, NM with the most Remote Credentialing Specialist job openings:
Remote Credentialing Specialist jobs near you
Infographic showing various Remote Credentialing Specialist job openings in Rio Rancho, NM as of July 2026, with employment types broken down into 72% Full Time, 16% Part Time, 6% Temporary, and 6% Contract. Highlights an 100% Remote job distribution, with an average salary of $47,656 per year, or $22.9 per hour.
Network Management Specialist - New Mexico Resident

Network Management Specialist - New Mexico Resident

Magellan Health, Inc.

Albuquerque, NM • On-site, Remote

$45K - $68K/yr

Full-time

Medical, Life

Re-posted 10 days ago

Job description

This position is remote, but must be located in New Mexico.
This position is responsible for the support of all activities related to developing and maintaining the physician, practitioner, group, and/or facility, MPPS and organization services delivery system in small to mid-size market defined by membership, number of providers in delivery system, number of business operating units and lines of business. Interacts with all areas of organization to coordinate network management and network administration responsibilities.
  • Assesses network needs, analyzes network composition, and using organization databases, application of regulatory requirements, accreditation entities and other resources, recruits individual, group and/or organizational providers to meet network adequacy standards and assure quality network.
  • Conducts and coordinates contracting and amendment initiatives.
  • Provides issue resolution and complex trouble shooting for providers.
  • Conducts provider education and provider relation activities, providing necessary written materials.
  • Conducts administrative provider site visits and coordinates report development and completion according to contractual requirements or ad hoc requests.
  • Coordinates Public Policy Research Center (PPRC) activities to assure maintenance of current credentialing status, and evaluation and appropriate actions of quality of care issues and complaints against providers.
  • Conducts and manages ongoing audits of provider compliance with Magellan policies and procedures as well as contractual obligations for multiple customers. Develops work plans to address audit requirements.
  • Works with management to draft, clarify and recommend changes to policies which impact network management.

The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.
Other Job Requirements
Responsibilities
Knowledge of National Committee for Quality Assurance (NCQA) requirements.
Ability to work independently and prioritize activities.
Intermediate knowledge of Microsoft Office Suite, specifically Excel.
Strong presentations skills using PowerPoint.
Minimum of 1 year experience in related position/field.
General Job Information
Title
Network Management Specialist - New Mexico Resident
Grade
21
Work Experience - Required
Network
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
Bachelor's
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$45,655
Salary Maximum:
$68,485
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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