Licensing and Credentialing Specialist

Job Summary

To support a growing practice, the full-time Licensing and Credentialing Specialist will manage end-to-end payer enrollment activities and provider licensing operations, ensuring timely enrollment and compliance while working remotely.

Key Responsibilities

• Own the end-to-end payer enrollment process for new and existing providers across commercial, Medicare, and Medicaid health plans
• Submit, track, and follow up on payer enrollment applications to ensure timely provider participation and minimize delays
• Collaborate with internal and external stakeholders to resolve enrollment issues and maintain accurate provider data across multiple platforms

Required Qualifications

• Bachelor's Degree in Healthcare administration or related field
• 3+ years of experience in provider payer enrollment and credentialing
• Experience managing provider enrollments with commercial, Medicare, and Medicaid payers
• Working knowledge of CAQH, payer portals, and provider credentialing systems
• Understanding of NCQA, CMS, state licensing, and payer credentialing requirements