Credentialing Lead: Build a New Service Line (Remote/Hybrid)

MEDINEX HEALTHCARE SOLUTIONS, LLC; Celebration (FL); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Flexible hybrid or remote work options

Comprehensive benefits package

Certification reimbursement

Leadership opportunity to build a new专

Job summary

MEDINEX HEALTHCARE SOLUTIONS, LLC in Florida seeks a Medical Insurance Credentialing Lead to design, launch, and lead a new credentialing and payer enrollment function. You will build workflows, manage enrollments, ensure compliance, and create scalable service offerings.

The role combines strategic program development with hands-on credentialing work, including hiring and supervising a Credentialing Assistant as volume grows, and ensuring timely, compliant payer interactions across Medicare,

Qualifications

• 4+ years of progressive medical insurance credentialing experience.
• Demonstrated success managing Medicare, Medicaid, and major commercial payer enrollments.
• Strong working knowledge of CAQH ProView, PECOS, NPPES, and payer enrollment platforms.
• Experience managing multiple providers and practices concurrently.
• Excellent organizational and communication skills.

Responsibilities

• Design and launch the organization’s credentialing and re-credentialing program from the ground up.
• Develop credentialing workflows, tracking tools, turnaround standards, and SOPs.
• Partner with leadership to support credentialing as a formal service offering.
• Manage full lifecycle of provider credentialing and enrollment for physicians and APPs.
• Hire, train, and supervise a Credentialing Assistant as volume grows.
• Maintain compliant provider credentialing files and attestations in CAQH ProView, PECOS, and payer portals.
• Collaborate with billing/RCM to align credentialing with claims workflows.

Skills

Credentialing leadership

Payer enrollment

Organizational skills

Education

Bachelor's degree in Healthcare Administration or related field

Tools

CAQH ProView

PECOS

NPPES

Job description

MEDINEX HEALTHCARE SOLUTIONS, LLC in Florida seeks a Medical Insurance Credentialing Lead to design, launch, and lead a new credentialing and payer enrollment function. You will build workflows, manage enrollments, ensure compliance, and create scalable service offerings.

The role combines strategic program development with hands-on credentialing work, including hiring and supervising a Credentialing Assistant as volume grows, and ensuring timely, compliant payer interactions across Medicare,