Credentialing Specialist / Provider Enrollment

We’re shaking up the traditional medical industry and creating a dynamic work environment that’s focused on innovation, teamwork, and a family-feel. Our team is passionate about growth, building authentic relationships, and making a real difference in the lives of our patients. But we don’t stop there – at Fraser eye, we believe in taking care of our own. That’s why we offer a wide range of career paths and unbeatable benefits, so you can grow and thrive with us. If you’re ready to take your career to the next level and be a part of something truly special, come join us at Fraser Eye Care! Location: Fraser, MI Job Id: 305 # of Openings: 1 Position Summary The Credentialing Specialist is responsible for coordinating all aspects of provider and facility credentialing, licensing, and payer enrollment. This role ensures that providers and facilities are properly credentialed, enrolled, and maintained within medical insurance networks in compliance with regulatory requirements and organizational standards. The specialist works closely with providers, payers, and internal departments to support timely onboarding and uninterrupted reimbursement. Key Responsibilities Collect, review, and maintain provider documentation, including state licenses, DEA certificates, board certifications, malpractice insurance, and other required credentials Manage the end-to-end provider enrollment process with commercial and government payers Prepare and submit initial enrollment applications, revalidations, and updates to insurance networks Track application status and follow up with payers to ensure timely approval and network participation Maintain accurate and up-to-date provider records in internal systems and credentialing databases Oversee and maintain provider profiles in CAQH, NPDB, and NPPES ensuring attestations are current and complete Monitor license and certification expiration dates and coordinate timely renewals Ensure compliance with federal, state, and payer-specific credentialing and enrollment requirements Complete and maintain required training related to licensing, credentialing, and payer enrollment processes Serve as a liaison between providers, insurance companies, and internal departments to resolve credentialing or enrollment issues Assist with audits and provide documentation as requested Qualifications Associate’s or Bachelor’s degree in healthcare administration, business, or related field preferred 2+ years of experience in provider credentialing and enrollment required Strong knowledge of insurance payer enrollment processes, including Medicare and Medicaid Experience working with CAQH and credentialing software systems Understanding of provider licensing requirements and regulatory standards Strong organizational skills with attention to detail and accuracy Ability to manage multiple deadlines and prioritize effectively Excellent communication and follow-up skills Preferred Skills Experience with multi-state licensing and credentialing Familiarity with accreditation standards (e.g., AAAHC, CHAMPS, PECOS, CAQH) Here are just a few highlights of what we offer: #J-18808-Ljbffr