Credentialing Services
Get Providers Credentialed and Billing Faster
End-to-end provider credentialing, payer enrollment, and CAQH/PECOS management for health systems, medical groups, and payers. Maximus BPO keeps your providers in-network and billing — without the paperwork backlog.
4000+
EXPERT AGENTS
45+
LANGUAGES
98%
CSAT RATING
01
Primary Source Verification
5-day turnaround
02
Payer Enrollment
30% faster approvals
03
CAQH Management
100% profile accuracy
Selected for our standards. Relied on by leaders.
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What we do
Credentialing BPO Services That Keep Providers Billing
Experienced credentialing specialists, CAQH experts, payer enrollment coordinators, and compliance pros — one partner covering the operations that keep providers verified, enrolled, and in-network.
01
Primary Source Verification
Direct verification of licenses, education, board certifications, DEA/NPI, and work history with issuing sources — accurate, audit-ready files every time.
02
Payer Enrollment & Follow-Up
End-to-end enrollment with Medicare, Medicaid, and commercial payers, plus persistent follow-up until approval — no application left waiting in a queue.
03
CAQH Profile Management
Ongoing CAQH ProView upkeep: attestations, document uploads, and re-attestation reminders so profiles never lapse.
04
License & Certification Tracking
Real-time monitoring of expiration dates across every state license, DEA registration, and board certification, with renewal alerts built in.
05
Re-Credentialing & Roster Management
Scheduled re-credentialing cycles and payer roster updates that keep every provider active and in-network.
06
Hospital Privileging Support
Full privileging application packages, reference verification, and committee-ready files for hospital medical staff offices.
MORE SERVICES
07
NPI & PECOS Enrollment
Type 1 and Type 2 NPI registration and PECOS enrollment/revalidation managed start to finish.
08
Delegated Credentialing Support
Audit-ready delegated credentialing programs, including NCQA-aligned file structure and payer audit support.
09
Provider Data Management
Clean, consistent provider data across your CVO, payer portals, and directories — fewer directory errors, fewer denied claims.
10
Exclusion & Sanction Monitoring
Ongoing OIG, SAM, and state exclusion list monitoring so no sanctioned provider slips through.
Solutions
Challenges You'll Overcome With Credentialing BPO
Credentialing is a moving target — payer requirements shift, licenses expire, and one missed deadline can take a provider off a panel. We handle the tracking and paperwork so your providers stay billable.
Slow payer enrollment timelines
THE CHALLENGE: New provider enrollments can sit with payers for 60–120 days, delaying billing and revenue.
OUR SOLUTION: Our team manages applications end-to-end with persistent payer follow-up to keep every submission moving.
IMPACT: 30% faster payer approval timelines
Expiring licenses and certifications
THE CHALLENGE: A single missed license or DEA renewal can pull a provider out of network overnight.
OUR SOLUTION: Automated tracking and proactive renewal reminders across every state license and certification.
IMPACT: Zero lapsed credentials across managed rosters
CAQH profile upkeep
THE CHALLENGE: CAQH ProView attestations lapse every 120 days, and a stale profile stalls every payer tied to it.
OUR SOLUTION: Continuous CAQH monitoring, document uploads, and attestation management.
IMPACT: 100% CAQH profile accuracy maintained
Staffing credentialing specialists
THE CHALLENGE: Hiring and training in-house credentialing staff takes months and is expensive to scale.
OUR SOLUTION: A ready, trained credentialing team that scales up or down with your provider roster.
IMPACT: Teams fully onboarded in as little as 3 weeks
NCQA and payer audit readiness
THE CHALLENGE: Delegated credentialing audits demand file structure and documentation that’s easy to get wrong.
OUR SOLUTION: NCQA-aligned file builds and audit-ready documentation on every provider file.
IMPACT: Consistently clean delegated audit results
Technology
Technology Stack for Credentialing Operations
The credentialing and enrollment platforms your organization already runs on — worked in every day by our teams.
CAQH ProView
PECOS
NPPES
Availity
NPDB
symplr
Choose Maximus BPO
Ready to clear the credentialing backlog holding up your providers?
Let’s discuss where enrollment delays and expiring credentials are costing you revenue — and how a Maximus program could get providers billing faster.
Why Maximus BPO
More than a credentialing BPO provider
We’re a partner invested in keeping your providers verified, enrolled, and billable — not just processing paperwork.
4000+
EXPERT AGENTS
30+
INDUSTRY AWARDS
98%
CSAT RATING
5+
YEARS PARTNERSHIP
01
Credentialing-trained specialists
Every agent is trained on CAQH, PECOS, NCQA standards, and payer-specific enrollment requirements before touching a live file.
02
Guaranteed accuracy
Dual-review file checks and audit-ready documentation on every provider record, every time.
03
Payer relationship follow-through
We don’t just submit — we follow up with payers until enrollment is confirmed.
04
Partnerships built to last
Building strategic partnerships on trust and turnaround time, not transactional client-vendor relationships.
Case Study
Real results for provider enrollment
Decades of BPO experience have taught us what actually moves the needle for provider enrollment and revenue.
CREDENTIALING & PAYER ENROLLMENT
Multi-Specialty Group Cuts Payer Enrollment Time by 35% in 120 Days
A dedicated credentialing team and structured payer follow-up program helped a multi-specialty medical group clear a 200-provider enrollment backlog and get new hires billing faster.
35%
FASTER PAYER ENROLLMENT
100%
CAQH PROFILE ACCURACY
0
LAPSED CREDENTIALS
$1.8M
RECOVERED BILLABLE REVENUE
Payer Enrollment
Primary Source Verification
Provider Data Management
Client Reviews
What our clients are saying
Direct feedback from the credentialing and provider ops teams we work with every day.
5.0
CLUTCH
“Maximus took our provider enrollment backlog from 90 days to under 60 without adding headcount on our end.”
JT
Director of Provider Enrollment
Multi-Specialty Medical Group
4.8
CLUTCH
4.9
G2
4.8
GARTNER
5.0
UPCITY
4.9
GOODFIRMS
Get Started
Use credentialing BPO to keep your providers billing
A 30-minute call is enough to map your enrollment workflow, benchmark it against the credentialing programs we run today, and show you where the fastest wins live.
FAQ
Frequently asked questions
Questions worth asking any credentialing BPO partner before you sign.
What is credentialing BPO?
Credentialing BPO — or credentialing business process outsourcing — is when a healthcare organization hands its provider credentialing, payer enrollment, and CAQH management work to a dedicated outside team. Maximus manages primary source verification, payer applications, license tracking, and re-credentialing so your internal team isn’t buried in paperwork.
Is Maximus HIPAA compliant?
Yes. Every Maximus engagement operates under a fully-executed BAA, with SOC 2 Type II and HITRUST controls audited annually. All agents complete HIPAA training before touching a live provider file.
Which credentialing platforms do you support?
We work directly in CAQH ProView, PECOS, NPPES, Availity, NPDB, and symplr, along with most major CVO and payer portal systems. Our teams train on your specific instance and workflows.
How fast can you scale a credentialing team?
Our standard onboarding runs 3–4 weeks from signed contract to a fully trained credentialing team live on your files. For urgent backlogs, we can stand up a dedicated surge team faster.
Can you handle multi-state and multi-specialty credentialing?
Yes. Our teams manage credentialing across all 50 states and every major specialty, tracking state-specific licensing rules and payer requirements so nothing falls through.
What types of organizations do you support?
Health systems, medical groups, ambulatory practices, telehealth companies, payers, and credentialing verification organizations (CVOs) — anywhere provider enrollment and re-credentialing needs to run reliably at scale.