Credentialing Specialist – Payer Enrollment

This is a fully remote position, open to applicants in Texas.

📋 Description

• Prepare, submit, and monitor enrollment applications, re-credentialing packets, and demographic updates with both commercial and government payers.

• Liaise with insurance representatives to track the status of applications, rectify processing errors, and expedite approval timelines.

• Oversee, update, and audit provider information within centralized databases, including CAQH, PECOS, and NPPES.

• Collaborate with billing, compliance, and operations teams to ensure enrollment data is synchronized across practice management systems.

• Investigate and resolve claim rejections or delays stemming from provider enrollment or taxonomy issues.

• Enroll healthcare facilities with commercial insurance payers, Medicare, and Medicaid to guarantee timely reimbursement.

⛳️ Requirements

• At least two years of experience in payer enrollment.

• Comprehensive knowledge and understanding of the credentialing and enrollment processes.

• Strong familiarity with medical provider identifiers such as NPI (National Provider Identifier) and TIN (Tax Identification Number).

• Ability to effectively organize and prioritize tasks while managing multiple responsibilities.

• Exceptional verbal and written communication skills.

• Keen attention to detail.

• Capacity to build and maintain effective working relationships with providers, management, staff, and external contacts.

• Proficient in Microsoft Office applications (Word, Excel, SharePoint) and credentialing software.

• Experience with MD Staff software is a plus.

🏝️ Benefits

• Comprehensive health insurance options.

• Retirement savings plans with employer matching.

• Paid time off and holiday benefits.

• Opportunities for professional development and continuing education.