Credentialing Specialist

Job Summary

To support a growing telehealth platform, the full-time Credentialing and Enrollment Specialist will manage the credentialing and enrollment processes for clinicians, ensuring compliance with payor networks and maintaining accurate provider records remotely.

Key responsibilities

• Review and verify provider credentialing applications for compliance with industry standards
• Submit enrollment packets to payors accurately and in a timely manner, while monitoring enrollment status
• Act as a liaison between providers, payors, and internal teams to resolve credentialing and enrollment issues

Required qualifications

• Associate's degree or equivalent combination of education and experience
• 3-5 years of experience in a credentialing and enrollment setting
• Knowledge of multi-state/national provider credentialing and enrollment processes
• Experience with PECOS/Medicare and state Medicaid enrollment platforms
• Certification as a Certified Provider Credentialing Specialist (CPCS) is a plus