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Role Description

The Credentialing & Enrollment Specialist owns provider enrollment workflows from onboarding through active payer participation. This role ensures providers are properly credentialed, compliant, billable, and accurately represented on payer directories. This is a deadline-driven, detail-intensive remote role that requires persistence and consistent follow-up with payers. Submission is not the finish line — verification is. You will be trusted — and your accuracy and tenacity will be visible.

• Submit and track payer enrollment applications (Medicare, Medicaid, commercial plans)
• Maintain and attest CAQH profiles
• Manage PECOS and Medicare enrollment processes
• Follow up proactively with payers to prevent delays
• Manage recredentialing and revalidation cycles
• Maintain provider licenses, DEA, malpractice, and expirables
• Submit roster updates and demographic changes
• Ensure provider data is consistent across systems
• Actively confirm providers are visible and correctly listed on payer directories
• Escalate and resolve directory discrepancies until corrected
• Maintain credentialing trackers and enrollment timelines
• Communicate billable and visibility status clearly

Qualifications

• Minimum 2 years hands-on credentialing or payer enrollment experience
• Direct experience with CAQH
• Experience working in payer portals
• Understanding of Medicare enrollment (PECOS)
• Experience resolving payer discrepancies
• Strong organizational skills
• Comfort working independently in a remote environment
• Private, distraction-free home workspace
• Reliable high-speed internet
• Full availability during scheduled work hours

Requirements

• Full-time (40 hours/week)
• Must be available for the entire scheduled shift
• Ongoing productivity and workflow monitoring
• This role is best suited for individuals who prefer structured processes, clear timelines, and measurable operational outcomes.

Compensation & Benefits

• $17–$20/hour depending on experience
• PTO and paid holidays
• Health, dental, and vision benefits
• 401(k) plan
• $50/month technology stipend