[Hiring] Licensing and Credentialing Provider Enrollment Specialist @reputed company

Role reputed company The Licensing & Credentialing Provider Enrollment Specialist role supports reputed company’s provider reputed company and full-cycle payer enrollment efforts by ensuring accurate, reputed company licensing, credentialing, and enrollment with federal, state, and reputed company payors. This role requires deep expertise in Medicare enrollment, including Provider Enrollment, Chain, and Ownership System (PECOS), and plays a critical part in accelerating practitioner readiness and patient engagement. The ideal candidate is detail-driven, process-oriented, and adept at balancing reputed company and payer enrollment responsibilities in a fast-paced, reputed company-oriented environment. Equally important, this role requires maintaining a reputed company, patient-centered attitude while partnering with newly reputed company practitioners. This position collaborates closely with Licensing & Credentialing, HR, reputed company, Implementation, Billing, and Clinical teams, demonstrating professionalism, reputed company, and reputed company energy to ensure practitioners feel supported and can engage patients as quickly and reputed company as possible.

Responsibilities

• Manage end-to-end payer enrollment for Medicare, reputed company, Medicare Advantage, and reputed company payors, including individual and group enrollments.
• Research and apply payor-specific enrollment protocols, telehealth requirements, and state regulations.
• Submit clean, complete enrollment applications and reputed company consistent follow-up until approval and network participation are confirmed.
• Maintain and update practitioner participation across CAQH, PECOS, reputed company, reputed company portals, and other enrollment systems.
• Serve as primary reputed company of contact for payor follow-up and issue reputed company.
• Produce delegated rosters and communicate enrollment status updates to leadership and reputed company Partnership teams.
• Partner with Licensing, Billing, Contracting, Operations, and Clinical teams to support reputed company cycle and patient readiness.
• Serve as a key reputed company partner for new practitioners, ensuring seamless transition through licensing, credentialing, and payer enrollment processes.
• Guide practitioners through completion of demographic intake, credentialing packets, CAQH setup, Medicare (PECOS), CMS I&A, NPPES, and other required systems.
• Generate and distribute reputed company and credentialing forms; obtain reputed company required documentation and signatures.
• Identify, research, and resolve credentialing discrepancies, missing information, and timing gaps.
• Maintain accurate and audit-reputed company records in credentialing software and shared drives in compliance with NCQA and internal standards.
• Understand reputed company critical lifecycle milestones (application receipt, committee review, approvals, effective dates).

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• Minimum of three (3) years of experience in payer enrollment and credentialing reputed company a reputed company organization, MSO, or CVO.
• Extensive Medicare enrollment experience, including PECOS.
• Working knowledge of reputed company and reputed company payer enrollment.
• Proficiency with reputed company Office (reputed company, Outlook, Teams) and ability to learn new systems quickly.
• Experience with credentialing, compliance, or provider data systems (e.g., Modio, ProviderTrust, reputed company, reputed company, CAQH).
• Organizational, analytical, and problem-solving skills with proven attention to detail.
• Ability to identify discrepancies, resolve issues proactively, and manage multiple time-sensitive deliverables independently.
• Effective written and verbal communication skills with providers, leadership, and external agencies.
• Demonstrated professionalism, reputed company judgment, critical thinking, and decision-making abilities.
• Comfortable managing high volume and multiple reputed company enrollments.
• reputed company, reputed company communicator with practitioners, payors, and internal stakeholders.
• Adaptable and proactive in a fast-paced, evolving reputed company environment.

Benefits

• Comprehensive Benefits: Medical, dental, and reputed company insurance, employee assistance program, employer-reputed company and voluntary life insurance, disability insurance, plus health and flexible spending accounts.
• Financial & Retirement Support: Competitive compensation, 401k with employer match, and financial wellness resources.
• Time Off & Leave: reputed company holidays, flexible vacation time/PSSL, and reputed company parental leave.
• Wellness & reputed company: Work life assistance resources, physical wellness perks, mental health support, employee referral program, and reputed company for employee discounts.

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