Senior Credentialing & Enrollment Specialist — Remote US

Carepatron; Philippines; Remote; PHP 600,000 - 1,000,000; Full time

Benefits offered by this job

Fully remote

Fixed US-hours schedule

Job summary

Carepatron is seeking a Senior Credentialing & Enrollment Specialist to own end-to-end credentialing for new RCM clients, including Medicare, Medicaid, and commercial payers. You will manage provider enrollment, CAQH/NPI setup, and payer contracting, ensuring clean submissions from the first billable submission.

You will partner with onboarding, customer success, and product teams to automate workflows and maintain accurate credentialing trackers.

Qualifications

• 5+ years of hands-on US provider credentialing and payer enrollment
• Experience with CAQH, NPPES, PECOS, and state Medicaid portals
• Strong multi-state enrollment experience and dealing with payers’ rules

Responsibilities

• Own credentialing and enrollment end-to-end for new RCM clients (Medicare, Medicaid, and commercial payers)
• Maintain CAQH profiles, NPI setup, and provider linking to groups
• Manage EFT/ERA enrollment and payer contracting tracking
• Re-credentialing and revalidation activities (CAQH re-attestation, expirables tracking)
• Escalate and resolve stalled payer processes and denials
• Collaborate with onboarding, customer success, and product teams to automate workflows

Skills

Provider credentialing

Payer enrollment

CAQH/NPPES/PECOS

Multi-state enrollment

English communication

Tools

CAQH DataSpring/DataSpring

NPPES

PECOS

Availity

Medallion/Verifiable/Modio

Job description

Carepatron is seeking a Senior Credentialing & Enrollment Specialist to own end-to-end credentialing for new RCM clients, including Medicare, Medicaid, and commercial payers. You will manage provider enrollment, CAQH/NPI setup, and payer contracting, ensuring clean submissions from the first billable submission.

You will partner with onboarding, customer success, and product teams to automate workflows and maintain accurate credentialing trackers.