Credentialing & Payer Enrollment Specialist

AmeriPharma; Laguna Hills (CA); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical/Dental/Vision

Life Insurance

401k

PTO & Sick Leave

Growth Opportunities

Team Outings

Casual Fridays

Employee Assistance

Job summary

AmeriPharma is seeking a Credentialing Specialist to manage the full credentialing lifecycle for facilities, from state licensing to payer enrollment. You will coordinate licensing, enrollment, and ongoing credentialing across states, ensuring compliance with regulatory and payer standards.

The ideal candidate will be detail-oriented with strong organizational and communication skills, experienced in HIPAA handling and regulatory requirements.

Qualifications

• Strong verbal and written communication skills.
• Excellent organizational skills and attention to detail.
• Knowledge of Medicare, Medicaid, CAQH, PECOS, NPPES; HIPAA familiarity.

Responsibilities

• Complete and submit initial and recredentialing applications for providers across all payers and facilities.
• Lead payer enrollment and re-enrollment processes with billing and operations teams.
• Track and organize credentialing documentation including licenses, DEA, NPI, and board certs.
• Ensure provider data accuracy and manage credentialing audits and renewals.

Skills

Communication

Interpersonal skills

Organizational skills

Time management

Regulatory knowledge

HIPAA familiarity

Education

Bachelor's degree in Healthcare Administration, Business, Finance, or related field

Tools

Microsoft Office

Job description

AmeriPharma is seeking a Credentialing Specialist to manage the full credentialing lifecycle for facilities, from state licensing to payer enrollment. You will coordinate licensing, enrollment, and ongoing credentialing across states, ensuring compliance with regulatory and payer standards.

The ideal candidate will be detail-oriented with strong organizational and communication skills, experienced in HIPAA handling and regulatory requirements.