Credentialing Specialist ($20-$24)

Position: Credentialing & Enrollment Specialist

Location: Remote

Compensation: $20-24/hour

Employment Type: Full-Time (40 hours/week)

Position Overview

The Credentialing & Enrollment Specialist is responsible for managing internal credentialing and payer enrollment processes to ensure healthcare providers are approved and participating with payer networks. This role helps improve patient access to care by ensuring timely and compliant enrollment.

The position requires familiarity with credentialing standards, internal workflows, and regulatory requirements. The specialist works closely with cross-functional teams and reports to departmental leadership while supporting broader organizational needs.

This role is ideal for someone who is detail-oriented, highly organized, and experienced in healthcare enrollment processes, with the ability to manage multiple workflows and ensure compliance with applicable standards.

Key Responsibilities

• Complete and manage enrollment applications, including gathering required provider documentation
• Maintain and verify provider credentials in accordance with regulatory and accreditation standards
• Track provider enrollment status, re-credentialing timelines, and renewals
• Update provider data across systems and communicate changes to relevant stakeholders
• Ensure accurate and up-to-date information in credentialing platforms and registries
• Monitor compliance with federal, state, and payer-specific requirements
• Conduct outreach to payers and external organizations to facilitate application processing
• Resolve enrollment and reimbursement issues through payer communication
• Support provider setup and maintenance within electronic health record systems
• Maintain records of licenses, credentials, and insurance documentation
• Monitor expiration dates and notify stakeholders of renewal requirements
• Conduct research on regulatory updates and credentialing best practices
• Assist with development and improvement of internal processes
• Provide support across credentialing and enrollment operations as needed

Preferred Qualifications & Skills

• Minimum of 3 years of healthcare credentialing and enrollment experience
• Strong knowledge of payer enrollment processes across multiple markets
• Experience communicating with payers and resolving enrollment-related issues
• Familiarity with credentialing tools and platforms (e.g., CAQH, PECOS, NPDB, NPI Registry)
• Experience working with third-party vendors in credentialing workflows
• Knowledge of electronic health record billing systems
• Proficiency with productivity and workflow tools (e.g., Google Workspace, project management platforms)
• Strong organizational, analytical, and problem-solving skills
• Ability to work independently and manage multiple priorities

Additional Attributes

• Experience collaborating in cross-functional or interdisciplinary teams
• Adaptability and comfort working in fast-paced or evolving environments
• Strong communication skills and ability to build effective working relationships
• Continuous improvement mindset with the ability to identify and implement process enhancements

Compensation

Hourly compensation ranges from $20 to $24 based on qualifications, experience, education, certifications, and other relevant factors.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance.