Provider Enrollment & Credentialing Specialist
Provider Enrollment & Credentialing Specialist
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Job Description
Key Responsibilities:
Manage the credentialing and re-credentialing processes for physicians nurse practitioners and physician assistants.
Enroll new providers with Medicare Medicaid and commercial insurance plans.
Maintain accurate and up-to-date provider information in internal databases and with payer systems.
Track expirables (e.g. licenses certifications malpractice insurance) and ensure timely renewals.
Communicate with providers and internal departments to gather necessary documentation and resolve enrollment or credentialing issues.
Monitor and respond to payer requests and follow up to ensure timely processing.
Stay current on enrollment and credentialing regulations and payer requirements.
Support facility privileging processes when applicable.
Qualifications:
2 years of experience in healthcare credentialing and/or provider enrollment.
Familiarity with CAQH PECOS NPPES and commercial insurance enrollment processes.
Strong organizational skills and attention to detail.
Ability to work independently and manage multiple tasks and deadlines.
Excellent communication skills both written and verbal.
Experience in wound care or with mobile healthcare providers is a plus.
Preferred Skills:
Knowledge of credentialing software and platforms.
Experience working with a geographically distributed provider team.
Understanding of state licensing requirements and compliance standards.
Why Join Us
Opportunity to be part of a mission-driven team making a direct impact on patient care.
Supportive and collaborative work environment.
Competitive salary and benefits package.
wound care
Education
MD, DO
Employment Type
Full Time
