Credentialing Coordinator

Job Summary

Supporting the healthcare provider compliance process, the full-time Credentialing and Enrollment Coordinator will verify provider qualifications and manage enrollment with government and commercial insurance payers in a remote capacity.

Key responsibilities

• Collect, verify, and maintain provider credentials, ensuring compliance with regulatory standards
• Enroll providers with Medicare, Medicaid, and commercial insurance payers, tracking application statuses and resolving any delays
• Maintain and update provider profiles in CAQH and manage communication with providers and insurance entities

Required qualifications

• Minimum of 1 year of experience in Medicare and/or Medicaid enrollment
• Familiarity with CAQH, PECOS, NPPES, and state-specific enrollment portals
• Working knowledge of medical terminology and healthcare/CMS regulations
• Strong organizational and time management skills with attention to detail
• Proficiency in data entry and management software