About the role
100% WFH / Remote
Provider Credentialing & Payer Enrollment
FULL CREDENTIALING LIFECYCLE
We’re looking for an experienced Credentialing Specialist who can independently manage provider credentialing and payer enrollment from start to finish across multiple payers and states.
This role requires someone who is highly organized, detail-oriented, persistent with payer follow-ups, and comfortable owning the credentialing process with minimal supervision.
MUST HAVE
Proven hands-on experience in provider credentialing and payer enrollment
Strong experience managing the full credentialing lifecycle
Hands-on experience with:
CAQH ProView
NPPES / NPI Registry
PECOS / Medicare enrollment
State Medicaid provider portals
Commercial payer portals, including Availity
Payer-specific enrollment systems
Strong understanding of Medicare, Medicaid, commercial, and behavioral health payer enrollment
Knowledge of taxonomy codes and provider enrollment documentation
Strong understanding of payer-specific credentialing and enrollment requirements
Excellent attention to detail and documentation
Strong follow-up skills and persistence with payers
Able to manage multiple providers, payers, states, and deadlines
Comfortable communicating with payer representatives and provider enrollment departments
Able to work independently with minimal supervision
KEY RESPONSIBILITIES
Credentialing & Enrollment
Manage initial payer enrollment, contracting, recredentialing, revalidation, and ongoing payer participation
Prepare, submit, and track applications from submission through approval and confirmed effective date
Complete enrollment with Medicare, Medicaid, managed-care plans, commercial, and behavioral health payers
Monitor and follow up on pending, incomplete, returned, and rejected applications
Resolve enrollment issues and follow applications through to approval
CAQH & Provider Records
Build and maintain CAQH ProView profiles
Complete initial setup, attestations, and reattestations
Ensure provider information is accurate and consistent across CAQH, payer portals, and internal records
Maintain complete provider files, including:
NPI Type 1 & Type 2
Taxonomy codes
State licenses
DEA registrations
Board certifications
Malpractice insurance
Provider demographics and practice information
Medicare / Medicaid / Payer Follow-Up
Submit and manage Medicare enrollment through PECOS
Complete state Medicaid and managed-care enrollment
Follow up with payer portals and provider-enrollment phone lines
Escalate payer delays or issues when necessary
Tracking & Compliance
Maintain a centralized credentialing tracker
Provide weekly credentialing status reports
Monitor upcoming recredentialing, revalidation, license, certification, and other expiration deadlines
Prevent credentialing and enrollment lapses
Maintain accurate, organized, and audit-ready documentation
Billing Coordination
Coordinate with billing to confirm payer enrollment and effective dates
Help ensure claims are not submitted before a provider is properly active with the payer
SUCCESS IN THIS ROLE
We’re looking for someone who can keep credentialing moving without constant follow-up from management.
The ideal candidate knows how to identify missing or inconsistent information early, stay on top of payer deadlines, persistently follow up on applications, and make sure providers become approved and active with the appropriate payers without avoidable delays or lapses.
Rate/offer determined based on experience and interview performance
We do not offer below $5.00/hour
HOW TO APPLY:
Only applicants who complete the application assessment/test will be processed. Shortlisted applicants will receive an interview invitation. If you did not receive an email from us within 1 week, it means you were not selected at this time.