Credentialing & Payer Enrollment Specialist

Socket.dev; Pittsburg (KS); On-site; USD 42,000 - 60,000; Full time

Job summary

CHC/SEK is seeking a Credentialing and Contracting Specialist to verify credentials and manage data for providers and facilities. The role ensures compliance with credentialing policies, supports enrollment with payers, and maintains accurate provider information within the electronic health record system.

Under supervision, you will perform verifications, manage CAQH/NPI data, and coordinate with stakeholders to ensure timely credentialing and contracting processes.

Qualifications

• High school diploma or equivalent is required.
• One year of experience in a healthcare office setting is preferred.
• Any combination of education and work experience that would likely provide the required knowledge and abilities is qualifying.

Responsibilities

• Verifies credentials, references, and claims history per policy.
• Conducts primary source verifications following State and Federal guidelines.
• Maintains confidential credentialing files and accurate provider databases.
• Coordinates DEA, license numbers, and NPI data for billing and enrollment.
• Communicates credentialing findings to the supervisor and stakeholders.
• Submits complete payer enrollment applications to obtain billing numbers.

Skills

Healthcare Office Experience

Credentialing Software

EMR System Proficiency

Attention to Detail

Education

High school diploma or equivalent

Tools

CAQH

NPI verification

KMAP

Job description

CHC/SEK is seeking a Credentialing and Contracting Specialist to verify credentials and manage data for providers and facilities. The role ensures compliance with credentialing policies, supports enrollment with payers, and maintains accurate provider information within the electronic health record system.

Under supervision, you will perform verifications, manage CAQH/NPI data, and coordinate with stakeholders to ensure timely credentialing and contracting processes.