Credentialing & Payer Enrollment Specialist

Angel Kids Pediatrics; Jacksonville (FL); On-site; USD 40,000 - 56,000; Full time

Job summary

Angel Kids Pediatrics in Jacksonville seeks a Credentialing and Payer Enrollment Coordinator to manage day-to-day provider enrollment with Medicaid, Medicare and commercial payers. You will maintain CAQH profiles, verify credentials, and coordinate recredentialing across multiple locations to prevent enrollment delays.

The role requires attention to detail, HIPAA-compliant handling of sensitive information, and collaboration with practice operations, scheduling, and revenue cycle teams.

Qualifications

• Experience coordinating credentialing and enrollment with payers and facilities.
• Knowledge of CAQH, NPPES, Medicaid/Medicare enrollment tools and payer portals.
• Familiarity with HIPAA and handling confidential information.
• Strong organizational skills and ability to manage multiple deadlines.

Responsibilities

• Manage provider onboarding and maintenance for physicians, APPs, and locations; submit enrollment docs to payers.
• Maintain CAQH profiles, attestations, licenses, and board status; track expirations.
• Perform primary source verification and escalate discrepancies to leadership.
• Verify milestones: credentialing approval, enrollment, effective date, billing readiness.
• Coordinate recredentialing, renewals, and changes; ensure downstream records reflect updates.
• Provide status reports on aging cases and escalate as needed.

Skills

Credentialing

Payer enrollment

CAQH familiarity

HIPAA compliance

Attention to detail

EHR systems

Education

Associate degree

Bachelor's degree preferred

Tools

EHR systems

CAQH portals

Job description

Angel Kids Pediatrics in Jacksonville seeks a Credentialing and Payer Enrollment Coordinator to manage day-to-day provider enrollment with Medicaid, Medicare and commercial payers. You will maintain CAQH profiles, verify credentials, and coordinate recredentialing across multiple locations to prevent enrollment delays.

The role requires attention to detail, HIPAA-compliant handling of sensitive information, and collaboration with practice operations, scheduling, and revenue cycle teams.