Credentialing & Payor Enrollment Specialist

Responsibilities

• Update and maintain CAQH profiles to ensure data accuracy and current attestations
• Manage time-sensitive credentials and proactive license renewals
• Enter provider applications into payer portals for enrollment
• Maintain accurate provider records and manage onboarding activities
• Collaborate with revenue cycle departments to achieve optimal results
• Respond to insurance payers' requests for information promptly
• Maintain confidentiality and uphold regulatory requirements

Requirements

• 1 to 3 years of relevant job experience
• High School Diploma, GED, or equivalent
• Proficiency in various HIS and Enrollment Software
• Intermediate proficiency in Excel
• Knowledge of understanding of PECOS and State Medicaid Portals
• Strong verbal and written communication skills

Preferred Qualifications

• Experience working with insurance enrollments
• Ability to solve problems and function independently
• Openness to innovation including AI to improve processes

Benefits

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive healthcare, time off, and retirement programs
• Career Advancement opportunities