Medical Credentialing Specialist – Provider Enrollment Expert

About the role

We are looking for a highly organized Medical Credentialing Specialist to join our revenue cycle management team. The role focuses on end‑to‑end credentialing and provider enrollment for a range of healthcare providers, with a strong emphasis on government payer processes.

Key responsibilities

• Manage complete credentialing, re‑credentialing, and enrollment for providers across commercial networks and government payers.
• Prepare, submit, and track Medicare applications via PECOS and state Medicaid enrollments.
• Create, update, and maintain provider profiles in CAQH and the NPPES NPI Registry.
• Monitor application statuses, follow up with payers to resolve delays, and troubleshoot denials.
• Track licenses, DEA certificates, malpractice insurance, and board certifications to avoid coverage lapses.
• Maintain accurate provider rosters and internal databases for clean claim submission.
• Communicate documentation requirements and status updates to providers, practice managers, and insurance representatives.

Required profile

• 2–3 years of direct experience in medical credentialing and provider enrollment.
• Extensive hands‑on experience with Medicare (PECOS) and Medicaid applications.
• Strong knowledge of CAQH, NPI, and state medical board licensing requirements.
• Excellent written and verbal communication skills.
• Ability to work independently and meet tight deadlines.

Required skills

• Medicare enrollment via PECOS
• State Medicaid enrollment portals
• CAQH Provider Credentialing
• NPPES NPI Registry management

What we offer

• Competitive salary based on experience
• Flexible working environment
• Opportunities for professional growth and skill advancement