Credentialing & Enrollment Specialist

Matter Healthcare; Nashville (TN); Hybrid; USD 60,000 - 75,000; Full time

Benefits offered by this job

Hybrid work schedule

Job summary

Matter Health is seeking an experienced Credentialing & Enrollment Specialist to manage provider credentialing, enrollment, and ongoing maintenance across markets. You will work closely with Clinical Operations, Revenue Cycle, Compliance, HR, and payer organizations to ensure timely activation of providers.

This role requires meticulous attention to detail, ability to manage multiple providers and deadlines, and a proactive approach to improving credentialing workflows.

Qualifications

• 3+ years of provider credentialing and payer enrollment experience.
• Independent management from application to approval.
• Knowledge of Medicare, Medicaid and commercial enrollment processes.

Responsibilities

• Manage all aspects of provider credentialing, recredentialing, and payer enrollment activities from start to finish.
• Prepare, submit, monitor, and maintain Medicare, Medicaid, and commercial payer enrollment applications.
• Maintain provider records in CAQH, PECOS, NPPES, and other relevant information systems.
• Track credentialing and enrollment timelines to ensure providers are approved and ready to practice.
• Coordinate provider demographic updates, revalidations, and enrollment changes with payer organizations.
• Monitor application status and proactively resolve credentialing and enrollment issues.
• Maintain accurate provider records and organize credentialing documentation.
• Collaborate closely with Clinical Operations, Compliance, Revenue Cycle, HR, and external organizations throughout the credentialing process.
• Ensure compliance with internal policies, regulatory requirements, and payer guidelines.
• Identify and implement opportunities to improve credentialing workflows, documentation, and operational efficiency.
• Support organizational growth by credentialing providers across new and existing markets.

Tools

CAQH

PECOS

NPPES

Availity

Enrollment portals

Job description

About Matter Health

Matter Health delivers primary and preventive healthcare directly to older adults living in affordable housing communities. Our mission is simple: to improve healthcare access by meeting patients where they are and building trusted relationships within the communities we serve. As we rapidly expand across the country, we are building a team of mission-driven professionals who thrive in fast-paced, collaborative environments.

Total Healthcare. Where you live.

About the Role

Matter Health is seeking an experienced Credentialing & Enrollment Specialist to join our growing team. In this role, you will manage the credentialing, enrollment, and ongoing maintenance of our physicians and advanced practice providers across multiple markets.

As a key member of our Credentialing & Enrollment team, you will ensure providers are credentialed, enrolled, and prepared to deliver care. You will collaborate closely with Clinical Operations, Revenue Cycle, Compliance, Human Resources, and external payer organizations.

This position is ideal for someone who takes ownership, thrives in a detail-oriented environment, and excels at keeping complex processes organized from start to finish. You will play a critical role in supporting Matter Health’s continued growth by guiding providers through the credentialing and enrollment lifecycle.

Responsibilities

• Manage all aspects of provider credentialing, recredentialing, and payer enrollment activities from start to finish
• Prepare, submit, monitor, and maintain Medicare, Medicaid, and commercial payer enrollment applications
• Maintain provider records in CAQH, PECOS, NPPES, and other relevant information systems
• Track credentialing and enrollment timelines to ensure providers are approved and ready to practice
• Coordinate provider demographic updates, revalidations, and enrollment changes with payer organizations
• Monitor application status and proactively resolve credentialing and enrollment issues
• Maintain accurate provider records and organize credentialing documentation
• Collaborate closely with Clinical Operations, Compliance, Revenue Cycle, HR, and external organizations throughout the credentialing process
• Ensure compliance with internal policies, regulatory requirements, and payer guidelines
• Identify and implement opportunities to improve credentialing workflows, documentation, and operational efficiency
• Support organizational growth by credentialing providers across new and existing markets

Qualifications

• 3+ years of provider credentialing and payer enrollment experience preferred
• Demonstrated experience independently managing credentialing and enrollment from application to approval
• Working knowledge of Medicare, Medicaid, and commercial payer enrollment processes
• Experience using CAQH, PECOS, NPPES, Availity, and payer enrollment portals
• Strong understanding of credentialing documentation requirements and provider lifecycle management
• Excellent organizational skills with the ability to manage multiple providers and deadlines simultaneously
• Meticulous attention to detail and a commitment to accuracy
• Exceptional written and verbal communication skills
• Ability to work independently while collaborating across multiple departments
• Proficiency with Microsoft Office, including Excel

Preferred Qualifications

• Experience within value-based care, primary care, physician groups, or Medicare Advantage organizations
• Experience supporting multi-state credentialing and enrollment
• Familiarity with delegated credentialing programs
• Experience working with advanced practice providers and physicians
• Knowledge of credentialing software and provider database management
• Process improvement or workflow optimization experience

What Success Looks Like

• Managing provider credentialing and payer enrollment with minimal supervision
• Maintaining accurate credentialing records and consistently meeting deadlines
• Building strong partnerships with providers, payers, and internal stakeholders
• Identifying and implementing enhancements to credentialing and enrollment processes
• Supporting Matter Health’s continued expansion by efficiently credentialing and enrolling providers
• Delivering exceptional service while maintaining compliance and operational excellence

Work Location

This role follows a hybrid work schedule. Team members are expected to work onsite at our Nashville office on a regular basis, with the flexibility to work remotely as well. Specific in-office days may be determined in collaboration with your manager.

Why Matter Health

We believe where someone lives should never determine the healthcare they receive. Every team member at Matter Health plays an important role in expanding healthcare access for older adults living in affordable housing communities. Our work removes barriers to care and improves lives through relationship-based healthcare.

If you are passionate about supporting providers, improving healthcare operations, and contributing to a mission-driven organization, we want to meet you.

Total Healthcare. Where you live.

Working at Matter Health

We are committed to supporting the whole person—at work and beyond. Full-time team member benefits begin the first of the month following your start date.

Health & Wellness

• Medical, dental, and vision coverage
• Employer-funded HSA and FSA options
• Employer-paid life and disability insurance
• Voluntary illness, accident, and hospitalization coverage
• Access to Matter Health’s in-person and virtual care services

Financial Security

• Competitive compensation
• 401(k) with company match beginning at Day 60
• Access to financial wellness resources

Time Away

• Up to 4 weeks of Paid Time Off
• 10 paid company holidays
• 2 volunteer days annually

Equal Opportunity Employer

Matter Health is an equal opportunity employer committed to building a diverse and inclusive workplace. We welcome applicants from all backgrounds and experiences and are dedicated to creating an environment where every team member feels valued, respected, and supported.