Provider Enrollment & Credentialing Specialist

Job Description
Job Title: Provider Enrollment & Credentialing Specialist

Company: Pinnacle Wound Management

Location: Gainesville, GA

Employment Type: Full-Time

About Us:

At Pinnacle Wound Management, we are dedicated to improving the lives of patients through high-quality wound care delivered by expert physicians, nurse practitioners, and physician assistants. As a growing leader in this specialized healthcare field, we're looking for a detail-oriented and proactive Provider Enrollment & Credentialing Specialist to support our expanding clinical team.

Position Overview:

The Provider Enrollment & Credentialing Specialist will be responsible for the full-cycle credentialing and enrollment of our healthcare providers, including physicians and mid-level practitioners. This role is vital to ensuring that our clinical staff are enrolled with payers, credentialed with facilities, and compliant with all regulatory and operational standards.

Key Responsibilities:

• Manage the credentialing and re-credentialing processes for physicians, nurse practitioners, and physician assistants.
• Enroll new providers with Medicare, Medicaid, and commercial insurance plans.
• Maintain accurate and up-to-date provider information in internal databases and with payer systems.
• Track expirables (e.g., licenses, certifications, malpractice insurance) and ensure timely renewals.
• Communicate with providers and internal departments to gather necessary documentation and resolve enrollment or credentialing issues.
• Monitor and respond to payer requests and follow up to ensure timely processing.
• Stay current on enrollment and credentialing regulations and payer requirements.
• Support facility privileging processes when applicable.

Qualifications:

• 2+ years of experience in healthcare credentialing and/or provider enrollment.
• Familiarity with CAQH, PECOS, NPPES, and commercial insurance enrollment processes.
• Strong organizational skills and attention to detail.
• Ability to work independently and manage multiple tasks and deadlines.
• Excellent communication skills, both written and verbal.
• Experience in wound care or with mobile healthcare providers is a plus.

Preferred Skills:

• Knowledge of credentialing software and platforms.
• Experience working with a geographically distributed provider team.
• Understanding of state licensing requirements and compliance standards.

Why Join Us?

• Opportunity to be part of a mission-driven team making a direct impact on patient care.
• Supportive and collaborative work environment.
• Competitive salary and benefits package.