Credentialing & Payer Enrollment Specialist

Modena Health; United States; Remote; USD 37,000 - 47,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) with matching

Paid time off

Job summary

Modena Health is seeking a Credentialing Specialist in the United States to prepare, submit, and manage provider credentialing and payer enrollment for commercial, Medicare, and Medicaid plans.

You will coordinate initial credentialing, recredentialing, and ongoing provider data maintenance for physicians and advanced practice providers, maintaining CAQH/NPI records and state licenses. This is a full-time, on-site role with comprehensive benefits.

Qualifications

• Minimum 2 years of provider credentialing or payer enrollment experience.
• Working knowledge of CAQH, PECOS, NPPES, and payer portals.
• Detail-oriented with strong organizational skills and ability to meet deadlines.

Responsibilities

• Prepare, submit, and manage credentialing and payer enrollment applications for commercial, Medicare, Medicaid, and other health plans.
• Coordinate initial credentialing, recredentialing, and provider data maintenance for physicians and advanced practice providers.
• Maintain accurate provider files, including CAQH profiles, NPI information, state licenses, DEA certificates, and other documentation.

Skills

Attention to detail

Organizational skills

Deadline management

Tools

CAQH

PECOS

NPPES

Job description

Modena Health is seeking a Credentialing Specialist in the United States to prepare, submit, and manage provider credentialing and payer enrollment for commercial, Medicare, and Medicaid plans.

You will coordinate initial credentialing, recredentialing, and ongoing provider data maintenance for physicians and advanced practice providers, maintaining CAQH/NPI records and state licenses. This is a full-time, on-site role with comprehensive benefits.