Credentialing & Enrollment Specialist

CareMore Health Management Services, LLC; Cerritos (CA); On-site; USD 33,000 - 60,000; Full time

Job summary

Mosaic Health in California is seeking a Credentialing & Enrollment Specialist to coordinate provider credentialing, recredentialing, and enrollment activities, ensuring NCQA, CMS, and state regulatory compliance. The role requires strong Excel skills, attention to detail, and excellent written and verbal communication to liaise with providers, networks, and internal teams.

You will manage inventories, review applications, conduct outreach for missing documents, track status across systems, and

Qualifications

• High school diploma or equivalent; associates or bachelor's preferred.
• Minimum 2 years healthcare credentialing or provider enrollment experience.
• Experience with health plans, provider groups, or managed care preferred.
• Strong Excel and data management skills.
• Excellent verbal and written communication.
• Ability to manage multiple priorities in a fast-paced environment.
• Knowledge of credentialing regulations and provider data management preferred.

Responsibilities

• Manage initial credentialing and recredentialing inventories to ensure timely completion.
• Review credentialing and enrollment applications for completeness and accuracy.
• Conduct outreach to providers and internal stakeholders to obtain missing documentation.
• Track credentialing status through systems and reports.
• Communicate credentialing approvals, denials, and status updates to providers and internal partners.
• Support provider enrollment activities with government and commercial payers.
• Maintain accurate provider records and databases.
• Prepare Excel spreadsheets, logs, and reports for audits.

Skills

Microsoft Excel

Verbal communication

Written communication

Attention to detail

Education

High school diploma or equivalent

Associate's degree

Bachelor's degree

Tools

CAQH

PECOS

NPPES

Availity

Job description

Mosaic Health in California is seeking a Credentialing & Enrollment Specialist to coordinate provider credentialing, recredentialing, and enrollment activities, ensuring NCQA, CMS, and state regulatory compliance. The role requires strong Excel skills, attention to detail, and excellent written and verbal communication to liaise with providers, networks, and internal teams.

You will manage inventories, review applications, conduct outreach for missing documents, track status across systems, and