Credentialing and Licensing Specialist

Coloplast

. Oversee initial and ongoing payer enrollment, credentialing, recredentialing, revalidation, and regulatory reporting activities .

Posted 10/10/2026full-timeRemote • Florida • United StatesMid-LevelSenior💰 $24 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in payer enrollment, credentialing, and regulatory compliance within the healthcare sector, with a strong focus on managing licenses and maintaining accurate payer information. Proficient in utilizing business software and maintaining compliance with Medicare and Medicaid standards.

Highest-signal resume keywords

Payer Enrollment ManagementCredentialing and RecredentialingRegulatory ComplianceHealthcare AdministrationMicrosoft Office Suite Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer EnrollmentCredentialingRegulatory ReportingData ManagementEFT/ERA EnrollmentLicensingContract ManagementHealthcare CompliancePayer Portal ManagementDME Industry Knowledge

Soft Skills

Strong Organizational SkillsAttention to DetailExcellent Communication SkillsTime ManagementProblem-Solving Skills

Industry Keywords

MedicareMedicaidHealthcare AdministrationDurable Medical EquipmentHIPAA ComplianceProvider RelationsManaged Care OrganizationsCommercial Health PlansBusiness LicensesAccreditation Requirements

About the role

Key responsibilities & impact

Oversee initial and ongoing payer enrollment, credentialing, recredentialing, revalidation, and regulatory reporting activities
Ensure compliance with federal, state, contractual, and payer-specific requirements
Obtain, renew, and maintain business and operational licenses and registrations, including Board of Pharmacy, HME/DMEPOS, facility, business, and Secretary of State filings
Manage payer information within patient management and billing systems
Process payer enrollment, revalidation, credentialing, and re-credentialing applications for Medicare, Medicaid, managed care organizations, commercial health plans, and other contracted payers
Monitor application status and perform follow-up to ensure timely participation and reimbursement
Manage payer portals, demographic maintenance, ownership updates, licensure updates, revalidations, and enrollment records
Manage company licenses, state DME permits, supplier registrations, business licenses, and accreditation requirements
Maintain Medicare supplier enrollment records and PECOS-related documentation
Prepare and submit ownership disclosures, corporate structure updates, adverse action disclosures, and other regulatory filings
Set up and maintain EDI enrollments, electronic claims submission processes, clearinghouse relationships, payer IDs, and payer connectivity
Process EFT and ERA applications
Maintain contract-related reference sheets, job aids, tracking sheets, and reference guides
Distribute internal communications regarding new payer contracts or policy changes
Maintain reimbursement fee schedules and payer-specific pricing information
Communicate contracted payer participation status to internal and external stakeholders
Assist the Market Access Team with commercial contract and health plan applications or credentialing initiatives
Maintain compliance with Medicare supplier standards, accreditation requirements, regulations, payer requirements, and company policies
Conduct business according to applicable laws, ethical standards, and company policies
Perform other duties as assigned

Requirements

What you’ll need

High school diploma or equivalent required
3-5 years of experience in healthcare administration, payer enrollment, credentialing, licensing, provider relations, or related support functions
Strong organizational skills with the ability to manage multiple priorities and meet deadlines
Proficiency in Microsoft Office Suite and other business-related software applications
Strong attention to detail and data entry accuracy
Ability to interpret instructions, policies, and payer requirements and complete tasks independently
Excellent verbal and written communication skills
Ability to adapt to changing priorities and work effectively in a fast-paced environment
Strong time management, problem-solving, and decision-making skills
Ability to work both independently and as part of a team
Experience with Medicare, Medicaid, commercial payers, or healthcare network operations preferred
Knowledge of payer enrollment, credentialing, contracting, licensing, or regulatory compliance processes preferred
Experience with payer portals, EFT/ERA enrollment, or provider/supplier data management preferred
Familiarity with HIPAA and healthcare privacy requirements preferred
Experience in the Durable Medical Equipment (DME) industry preferred

Benefits

Comp & perks

Comprehensive medical, dental, and vision insurance plans
Company-sponsored wellness programs
Mental health resources
Paid leave of absence for qualifying events
Generous paid parental leave for birthing and non-birthing parents
Competitive 401(k) plan with immediate company match vesting
Financial planning services
Corporate discount programs
Generous paid time off
Flexible work hours
Flexible work arrangement options may be available
Training programs
Mentorship
Tuition reimbursement
Recognition programs, including peer recognition
Bonuses
Awards and special events
Team-building activities
Volunteer opportunities
Company-sponsored events