Credentialing and Enrollments Specialist

. Prepare, submit, and manage provider credentialing and payer enrollment applications for commercial, Medicare, Medicaid, and other health plans .

Posted 9/25/2026full-timeRemote • United StatesJuniorMid-Level💰 $27 - $34 per hourWebsite

Key responsibilities & impact

Prepare, submit, and manage provider credentialing and payer enrollment applications for commercial, Medicare, Medicaid, and other health plans
Coordinate initial credentialing, recredentialing, and provider data maintenance for physicians and advanced practice providers
Maintain accurate provider files, including CAQH profiles, NPI information, state licenses, DEA certificates, malpractice insurance, board certifications, and other required documentation
Maintain credentialing, enrollment, and contracting records in CredentialStream and other designated databases
Monitor credentialing and enrollment statuses through payer portals and follow up to ensure timely approvals
Track expiration dates for licenses, certifications, malpractice coverage, and other required documents
Respond to payer requests for additional documentation or clarification
Communicate status updates to leadership, billing managers, clinic managers, providers, and other stakeholders
Assist with onboarding new providers, including credentialing timelines, payer enrollments, and hospital privileging requirements
Support provider offboarding, including payer terminations and record updates
Maintain confidentiality and ensure compliance with HIPAA and organizational policies
Proactively identify and resolve credentialing or enrollment delays
Maintain complete, accurate, and organized records and manage multiple provider enrollment timelines and deadlines

What you’ll need

High school diploma or equivalent required
Minimum of 2 years of experience in provider credentialing, payer enrollment, medical staff services, or healthcare administration required
Working knowledge of CAQH, PECOS, NPPES, and payer enrollment portals required
Experience maintaining provider records and credentialing databases, including CredentialStream or similar credentialing software
Strong attention to detail and organizational skills
Excellent written and verbal communication skills
Ability to prioritize tasks and manage multiple deadlines effectively
Ability to work independently and collaboratively in a remote environment
Proficiency in Microsoft Office Suite, EHR systems, practice management software, and online credentialing portals
Strong problem-solving and follow-up skills
Experience with commercial and government payer enrollment processes strongly preferred
Experience with hospital privileging and provider onboarding preferred
Prior experience in allergy, asthma, or specialty medical practices is a plus
Occasional overtime may be required
Ability to stand, walk, and move throughout the clinic, if applicable, for extended periods; occasionally lift objects up to 25 lbs., bend, stoop, or reach as needed
Frequent use of hands and fingers for patient care and equipment operation
Must have normal (or corrected) vision and hearing and be able to respond quickly in a fast-paced clinical environment, if applicable

Comp & perks