Credentialing/Payor Enrollment Specialist

Brave Health

. Manage the payor enrollment process in collaboration with the Director of Credentialing Operations.

Posted 10/27/2026full-timeRemote • Florida • United StatesMid-LevelSenior💰 $60,000 - $64,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing the payor enrollment process and credentialing documentation, ensuring compliance with Medicaid, Medicare, and private payer systems. Proficient in leveraging technology and tools to enhance efficiency and scalability in a fast-paced healthcare environment.

Highest-signal resume keywords

Credentialing/Payor Enrollment ExperienceKnowledge of Medicaid and Medicare SystemsNAMSS CPMSM or CPCS CertificationExperience with Credentialing PlatformsLeadership in Process Improvements

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Credentialing Documentation ManagementPrimary Source VerificationData Compilation and MaintenanceEnrollment Process ManagementEfficiency Opportunity Identification

Soft Skills

Highly OrganizedAbility to MultitaskAdaptability to Fast-Paced EnvironmentsProactive Problem Solving

Tools & Technologies

CAQHPECOSNPPESState-Specific Medicaid Portals

Certifications & Qualifications

NAMSS CPMSM CertificationNAMSS CPCS Certification

Industry Keywords

HealthcareCredentialingPayor EnrollmentTelehealthMulti-State Operations

About the role

Key responsibilities & impact

Manage the payor enrollment process in collaboration with the Director of Credentialing Operations.
Support clinical onboarding and ongoing enrollment, ensuring clinical providers are enrolled and renewed with health plans.
Compile and maintain current and accurate data for all clinical providers.
Manage credentialing documentation in databases and ensure timely enrollment and re-credentialing.
Perform primary source verification during initial credentialing and re-credentialing.
Maintain copies of enrollment forms, applications, and required documentation.
Maintain payor enrollment delegation rosters, including updates for new hires and former providers.
Partner with HR to ensure new providers are enrolled in health plans before their start date.
Assist new hires with Medicaid and Medicare applications, including reassigning Medicare benefits to Brave Health.
Address new-hire questions about payor enrollment and credentialing processes.
Ensure current credentialing documentation is submitted during onboarding for primary source verification.
Collaborate with vendors supporting payor enrollment processes.
Research new payor enrollment opportunities to enhance network participation.
Drive process and tool improvements as organizational needs evolve.
Identify efficiency opportunities, including outsourcing or new technology implementations.

Requirements

What you’ll need

Minimum of three years of relevant credentialing/payor enrollment experience required.
Strong knowledge of Medicaid, Medicare, and private payer insurance systems.
Highly organized with the ability to multitask and manage competing priorities effectively.
Skilled at working under pressure and adapting to the fast-paced, evolving needs of a startup environment.
Strong tools/automation orientation; proactive in seeking, evaluating, and recommending new technologies and tools to enhance scalability and efficiency.
NAMSS CPMSM or CPCS certification preferred.
Leadership experience in managing credentialing/payor enrollment teams or driving key process improvements preferred.
Associate’s or Bachelor’s degree in Healthcare, Business Administration, or a related field preferred.
Remote work experience strongly preferred.
Experience with Medicaid, Medicare, and commercial/private payers.
Experience with credentialing or payor enrollment platforms and databases such as CAQH, PECOS, NPPES, and state-specific Medicaid portals.
Experience collaborating with external vendors or partners to support credentialing or payor enrollment processes.
Experience in a healthcare startup, multi-state telehealth, or other fast-paced and rapidly growing healthcare environment.
At least one year of professional experience working in a fully remote role is requested in the application form.

Benefits

Comp & perks

Comprehensive health, dental, and vision coverage.
Generous paid time off, including parental leave.
Fully remote, work from home position.
All equipment provided.