Credentialing and Enrollments Specialist
Remote · United States or US
Job Summary
Credentialing and Enrollments Specialist responsible for managing credentialing, payer enrollment, and provider onboarding for physicians and advanced practice providers. Maintains provider files, monitors deadlines, coordinates with payers and providers, and ensures timely completion of credentialing and enrollment across commercial, Medicare, and Medicaid plans. Maintains accurate records (CAQH, NPI, licenses, DEA, malpractice, board certifications), tracks expirations, and supports onboarding and offboarding activities. Ensures HIPAA compliance and effective communication with leadership, billing, and clinic teams in a fast-paced, remote healthcare environment.
Required Qualifications
- High school diploma or equivalent
- Associate degree or higher preferred
- Minimum of 2 years of experience in provider credentialing, payer enrollment, medical staff services, or healthcare administration
- Working knowledge of CAQH, PECOS, NPPES, and payer enrollment portals
- Experience with hospital privileging and provider onboarding preferred
- Experience maintaining provider records and credentialing databases, including CredentialStream or similar credentialing software
- Strong attention to detail and organizational skills
- Excellent written and verbal communication skills
- Ability to work independently and remotely
- Proficiency in Microsoft Office Suite, EHR systems, practice management software, and online credentialing portals
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