Credentialing and Payor Enrollment Specialist

Ensemble Health Partners

. Update and maintain CAQH profiles, ensuring accurate data and current attestations .

Posted 11/10/2026full-timeUnited StatesJunior💰 $20 - $24 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Provider Enrollment processes, including managing CAQH profiles and insurance enrollments, while ensuring compliance with regulatory requirements. Strong attention to detail and problem-solving abilities are essential for maintaining accurate provider records and supporting onboarding activities.

Highest-signal resume keywords

Provider EnrollmentCAQH Profile ManagementInsurance Enrollment ExperienceIntermediate Excel ProficiencyStrong Verbal And Written Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider EnrollmentCAQH Profile ManagementInsurance EnrollmentData EntryAttention To DetailProblem SolvingTime ManagementRegulatory ComplianceOnboarding ProcessesProcess Improvement

Soft Skills

Customer ServiceCollaborationCommunicationInnovation OpennessIndependence

Tools & Technologies

HIS SoftwareEnrollment SoftwareDatabasesNPPESState Medicaid PortalsPayer WebsitesPayer Portals

Industry Keywords

CredentialingProvider RecordsLicense RenewalsConfidentialityRegulatory Requirements

About the role

Key responsibilities & impact

Update and maintain CAQH profiles, ensuring accurate data and current attestations
Maintain provider records and enter new providers or update data
Manage time-sensitive credentials, license renewals, and annual provider or location updates
Track and follow up on provider onboarding activities and statuses
Support strategic partners and internal counterparts with enrollment and credentialing inquiries and updates
Serve as a subject-matter expert for provider onboarding instructions and support
Collaborate with revenue cycle departments on initiatives and process improvements
Develop relationships, implement best practices, and redesign systems and processes
Identify client support and performance gaps and propose solutions
Address new issues with team members and respond promptly with acknowledgements or status updates
Use HIS and enrollment software, databases, CAQH, NPPES, licensing boards, and payer websites
Enter provider applications into payer portals and verify data accuracy and completeness
Respond to insurance payers’ requests for information
Work with outside vendors and facilities to enroll providers
Maintain confidentiality and uphold privacy and regulatory requirements
Provide excellent customer service
Escalate issues and potential deadline, standards, or goal risks to Credentialing and Enrollments leadership

Requirements

What you’ll need

1 to 3 Years of experience
High School Diploma, GED, or Equivalent Experience
Knowledge and understanding of Provider Enrollment, Chain, and Ownership System (PECOS)
Knowledge and understanding of State Medicaid Portals
Experience working with insurance enrollments, strongly preferred
Intermediate proficiency level in Excel
High level of attention to detail with the ability to solve problems and function independently
Prioritize and meet deadlines on an ongoing basis
Strong verbal and written communication skills
Openness to innovation including AI
Must reside and be authorized to work within the United States
Must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require

Benefits

Comp & perks

Bonus Incentives
Paid Certifications
Tuition Reimbursement
Comprehensive Benefits
Career Advancement
Healthcare
Time off
Retirement
Well-being programs
Professional development
Quarterly and annual incentive programs