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Remote Provider Credentialing Jobs in New Mexico

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Remote Provider Credentialing information

What is remote provider credentialing?

Remote provider credentialing refers to the process of verifying the qualifications, experience, licensure, and background of healthcare providers who work remotely. This is essential for ensuring that remote physicians, nurses, and other practitioners meet all regulatory and organizational standards before they deliver care. The process often involves collecting and reviewing documents, contacting licensing boards, and verifying work history, all conducted through secure online systems. Remote credentialing helps healthcare organizations maintain compliance and ensure patient safety while supporting flexible work arrangements.

What are some common challenges faced when managing provider credentialing in a remote work environment?

One of the main challenges in remote provider credentialing is staying organized while tracking multiple providers’ documents and deadlines across different systems. Communication can also be more complex, as coordination with healthcare providers, licensing boards, and insurance companies often requires timely follow-ups and clear digital documentation. Utilizing secure, cloud-based credentialing software and maintaining regular virtual check-ins with your team can help ensure deadlines are met and compliance is maintained. Proactively managing these aspects can reduce delays and support a smooth credentialing process.

What are the key skills and qualifications needed to thrive as a remote provider credentialing specialist, and why are they important?

To thrive as a Remote Provider Credentialing Specialist, you need a solid understanding of healthcare regulations, credentialing processes, and attention to detail, often supported by a bachelor's degree or relevant experience. Familiarity with credentialing software (such as CAQH, VerityStream, or MD-Staff) and knowledge of healthcare compliance standards are typically required. Excellent organizational skills, strong communication, and problem-solving abilities help you manage complex documentation and interact with providers and regulatory bodies. These skills are essential for ensuring providers meet all regulatory requirements, maintaining compliance, and supporting efficient healthcare operations.

What is the difference between Remote Provider Credentialing vs Remote Medical Billing Specialist?

AspectRemote Provider CredentialingRemote Medical Billing Specialist
Required CredentialsLicenses, certifications, provider documentationBilling codes, insurance knowledge, coding certifications
Work EnvironmentHealthcare organizations, credentialing firmsMedical offices, billing companies
Industry UsageHealthcare, provider networksHealthcare, insurance reimbursement
Search & Comparison IntentCredentialing process, provider verificationBilling procedures, reimbursement processes

Remote Provider Credentialing focuses on verifying healthcare providers' qualifications and licensing to ensure they meet industry standards. In contrast, Remote Medical Billing Specialists handle insurance claims, coding, and reimbursement processes. Both roles are essential in healthcare operations but serve different functions within the industry.

How to get into remote provider credentialing?

To enter remote provider credentialing, candidates typically need a background in healthcare administration, insurance, or related fields, along with knowledge of credentialing processes and compliance standards. Gaining experience with credentialing software and obtaining certifications such as the Certified Provider Credentialing Specialist (CPCS) can improve job prospects. Strong organizational skills and attention to detail are essential for managing provider documentation and ensuring regulatory adherence.

What skills are needed for remote provider credentialing jobs?

Remote provider credentialing jobs require strong organizational skills, attention to detail, and knowledge of healthcare regulations and credentialing processes. Proficiency in computer software such as Microsoft Office and credentialing databases is essential, along with good communication skills for coordinating with providers and insurance companies.

What are popular job titles related to Remote Provider Credentialing jobs in New Mexico?

For Remote Provider Credentialing jobs in New Mexico, the most frequently searched job titles are:

What job categories do people searching Remote Provider Credentialing jobs in New Mexico look for?

The top searched job categories for Remote Provider Credentialing jobs in New Mexico are:

Infographic showing various Remote Provider Credentialing job openings in New Mexico as of August 2026, with employment types broken down into 2% As Needed, 76% Full Time, 16% Part Time, 1% Temporary, and 5% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.

Remote PRN IP Facility PCS/ICD coder

Presbyterian Healthcare Services

Santa Fe, NM • On-site, Remote

$22.79 - $38.80/hr

Other

Medical, Dental, Vision, Life

Re-posted 18 days ago


Presbyterian Healthcare Services rating

7.2

Company rating: 7.2 out of 10

Based on 164 frontline employees who took The Breakroom Quiz

349th of 888 rated healthcare providers


Job description

Location Address:
Remote OfficeSanta Fe, NM 87501
Compensation Pay Range:
Minimum Offer $22.79Maximum Offer $38.80Now Hiring: Remote PRN IP Facility PCS/ICD coder
Summary:
Codes more than one of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers for the purpose of reimbursement, research and in compliance with Federal regulation according to diagnosis, operation and procedure using the ICD-9/10 CM and CPT-4 classification system. Ensures adherence to Hospital and Departmental Policies and ProceduresType of Opportunity: PRNJob Exempt: NoJob is based: Remote Workers New MexicoWork Shift: Varied Days and Hours (United States of America)
Responsibilities:
*Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
*Abstracts data essential to the QI department in determining patient care issues as well as providing information to The Joint Commission.
*Accesses several systems via the computer to research the medical record when needed to complete the coding in a timely manner. Takes responsibility for accounts receivable by looking for lost documents to insure all encounters are coded, including the generation of appropriate queries, as needed.
*Responsible for resolving any and all pre-bill edits, denials, etc for assigned accounts.
*Maintains and disseminates up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area. This includes but is not limited to all ICD-9/10 CM, CPT-4, HCPCS, DRG, APC and/or HHRG updates and changes.
*Participates in all departmental in-services and updates to stay current with the accepted coding guidelines and improve personal knowledge of medicine and treatment.
*Communicates issues to the EW Clinical Coding Manager & Supervisor, as appropriate.
*Must demonstrate knowledge of coding multiple areas of service and/or specialties.
*Maintains at least a 95% accuracy rate.
*Maintains average to high productivity based on PHS Productivity Standards.
*Maintains continuing education (CE) requirements per PHS policy
Qualifications:
High school diploma/GED required.
Must have any one of the following coding certifications at time of hire: HCS-D, CCS, CCS-P, CPC-H or CPC, or RHIT/RHIA with achievement of one of the coding credentials above within one year of hire.
One-three years experience as a coder required.
Must possess computer skills including, but not limited to, Word, Excel, PowerPoint.
Experience with an encoder preferred.
Experience with an Electronic Medical Record preferred.
Must be able to use the internet and other electronic resources for the purpose of research
UPDATED 8/27/25
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

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About Presbyterian Healthcare Services

Sourced by ZipRecruiter

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Albuquerque, NM, US

Year founded

1908

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