Credentialing Coordinator

Job Summary

To support a growing laboratory, the remote Credentialing & Enrollment Coordinator will manage payer enrollment processes, ensuring accurate billing and compliance with Medicare, Medicaid, and commercial payers while maintaining essential documentation and tracking application statuses.

Key responsibilities:

• Prepare, submit, and track laboratory enrollments and revalidations with various payers
• Manage EDI claim and EFT enrollments, coordinating with vendors for testing and implementation
• Maintain credentialing data and documents, ensuring compliance and tracking expiration dates

Required qualifications:

• Associate's degree required
• 3-5 years of credentialing and payer enrollment experience, including 2 years in a clinical laboratory or diagnostics setting
• Hands-on experience with Medicare, Medicaid, and commercial payer enrollments
• Working knowledge of CMS-855B, PECOS, NPPES, CAQH, and CLIA requirements
• Demonstrated experience with EDI (837) and ERA/EFT (835) enrollments