Credentialing & Payor Enrollment Specialist

Job Posting

We are dedicated to providing exceptional care to every patient, every time.

St. Luke's Hospital is a value-driven award-winning health system that has been nationally recognized for its unmatched service and quality of patient care. Using talents and resources responsibly, we provide high quality, safe care with compassion, professional excellence, and respect for each other and those we serve. Committed to values of human dignity, compassion, justice, excellence, and stewardship St. Luke's Hospital for over a decade has been recognized for "Outstanding Patient Experience" by HealthGrades.

Position Summary:

The Credentialing & Payor Enrollment Specialist manages the complete lifecycle of provider placement, including medical staff credentialing, allied health onboarding, and managed care plan enrollment. This role processes applications for appointments and reappointments while executing enrollment and re-credentialing processes for the medical group and hospital-based providers. Responsibilities include maintaining provider databases, updating CAQH registries, monitoring compliance tracking, and corresponding directly with health plans, government entities, and internal medical teams. This role heavily utilizes advanced office technology, automated database systems, and AI-driven productivity tools to optimize data accuracy, draft complex communications, and streamline administrative workflows. Given the highly sensitive nature of provider records, financial documentation, and peer review data, maintaining absolute confidentiality, strict information security, and compliance with privacy regulations is a core requirement of this position. All duties are performed in alignment with the department's core mission, structural values, and standard regulatory guidelines. Responsible for promoting teamwork with all members of the healthcare team. Performs all duties in a manner consistent with St. Luke's mission and values.

Education, Experience, & Licensing Requirements:

Education: High School Diploma or GED required

Experience: 2-3 years of medical staff credentialing and payor enrollment experience (Required). Operational understanding of governmental programs, standard managed care workflows, and medical group/hospital operations (Preferred)

Licensure: Professional Certification as a Provider Credentialing Specialist (Preferred) OR a matching tier of direct field experience

Benefits for a Better You:

• Day one benefits package
• Pension Plan & 401K
• Competitive compensation
• FSA & HSA options
• PTO programs available
• Education Assistance

Why You Belong Here:

You matter. We could not achieve our mission daily without the hands of our team. Our culture and compassion for our patients and team is a distinct reflection of our dynamic workforce. Each team member is focused on being part of something much bigger than themselves. Join our St. Luke's family to be a part of making life better for our patients, their families, and one another.