Credentialing & Payor Enrollment Specialist
$41,080–$48,880 year
RemoteUnited States
Job Summary
Update and maintain CAQH profiles, provider records, and payer portal applications to ensure data accuracy and timely enrollment. Manage time-sensitive credentials, license renewals, and annual updates while conducting follow-up on provider onboarding activities. Support strategic partners and internal counterparts by answering inquiries, providing enrollment updates, and serving as a subject-matter expert for onboarding instructions. Collaborate with revenue cycle departments to identify performance gaps, propose solutions, and implement best practices for process improvement. Verify data completeness, respond to payer information requests, and escalate complex issues to leadership. Requires 1–3 years of experience, proficiency in Excel and enrollment software, and the ability to travel to client or corporate offices as needed.
Required Qualifications
- High School Diploma, GED, or Equivalent
- 1 to 3 Years
Desired Qualifications
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Knowledge and understanding of Provider Enrollment, Chain, and Ownership System (PECOS)
- Knowledge and understanding of State Medicaid Portals
- Experience working with insurance enrollments
- Intermediate proficiency level in Excel
- High level of attention to detail with the ability to solve problems and function independently
- Prioritize and meet deadlines on an ongoing basis to ensure timely completion according to process requirements
- Strong verbal and written communication skills
- Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences
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