Credentialing Specialist

Page Mechanical Group, Inc.; Jacksonville (FL); Presencial; USD 65.000 - 75.000; Jornada completa

Descripción de la vacante

GlyCare is seeking an experienced Payer Enrollment Specialist to manage provider and group enrollment across multiple states. The ideal candidate is highly organized, navigates payer requirements, manages deadlines, resolves issues, and develops clear SOPs.

This onsite role supports hospital-based enrollment efforts and improves processes. This position requires at least two years of payer enrollment experience, with multi-state experience preferred, and collaboration across billing, operations,

Formación

• Minimum of two years of payer enrollment experience.
• Multi-state enrollment experience preferred.
• Experience with CAQH, NPPES, PECOS or state portals is desired.

Responsabilidades

• Manage provider and group enrollment with Medicare, Medicaid, and commercial payers.
• Track applications from submission through approval and effective-date confirmation.
• Maintain accurate provider information in CAQH, NPPES, PECOS and payer portals.
• Coordinate with internal teams and leadership on enrollment status and risks.

Conocimientos

Payer enrollment

Multi-state experience

Excel

Documentation

Communication

Herramientas

CAQH

NPPES

PECOS

Monday.com

Descripción del empleo

Payer Enrollment Specialist

About GlyCare

GlyCare is a hospital-based, consultative inpatient diabetes management service. Our Nurse Practitioners and Endocrinologists provide evidence-based glycemic management for non-ICU hospitalized patients, helping improve outcomes and standardize care.

We partner directly with hospitals - there are no outpatient clinics or traditional practice settings - and are rapidly expanding across multiple states.

Why Join GlyCare?

• Join a rapidly growing, hospital-based clinical program
• Support expansion into new states and markets
• Contribute directly to provider readiness and operational success
• Help build scalable enrollment processes

Position Overview

GlyCare is seeking an experienced Payer Enrollment Specialist to manage provider and group enrollment across multiple states.

The ideal candidate is highly organized and able to independently navigate payer requirements, manage multiple deadlines, resolve application issues, and develop clear SOPs. This role requires a critical and proactive thinker who can anticipate potential issues and provide accurate, timely updates to leadership.

• Salary Range: $65,000-75,000
• Experience: Minimum of two years of payer enrollment experience; multi-state experience preferred
• Schedule: Onsite Monday through Friday

What You'll Do

Payer Enrollment and Revalidation

• Manage provider and group enrollment with Medicare, Medicaid, and commercial payers
• Complete initial enrollments, provider additions, demographic updates, revalidations, group affiliations, and other required maintenance
• Maintain accurate provider information in CAQH, NPPES, PECOS, and state Medicaid portals
• Track applications from submission through approval and effective-date confirmation
• Complete timely and consistent follow-up on all submitted applications
• Resolve outstanding requirements, processing delays, and application discrepancies
• Communicate approvals, effective dates, delays, and enrollment risks to leadership and appropriate internal teams

Multi-State Expansion and Process Development

• Research state- and payer-specific enrollment requirements, timelines, and dependencies
• Develop and maintain SOPs, workflows, checklists, and training materials
• Create repeatable processes that support new providers, locations, and markets
• Identify inefficiencies and recommend practical process improvements

Tracking and Compliance

• Track applications, effective dates, revalidations, expirations, and follow-up deadlines
• Use online credentialing platforms and task trackers, including Monday.com, to manage progress and outstanding items
• Document submissions, payer contacts, approvals, and follow-up activity
• Review applications and supporting documentation for completeness and accuracy
• Monitor payer-required licenses, certifications, malpractice coverage, and other provider documents
• Maintain organized, accurate, and audit-ready electronic files

Internal Coordination

• Coordinate with billing, operations, clinical leadership, providers, and other internal stakeholders
• Provide leadership with clear updates on application status, outstanding items, expected effective dates, and potential delays
• Support provider onboarding by identifying and collecting payer-required information
• Escalate risks early with a clear summary of the issue and planned next steps
• Serve as an internal resource for payer enrollment questions

What We’re Looking For

• At least two years of payer or provider enrollment experience
• Experience enrolling individual providers and groups with Medicare, Medicaid, and commercial payers
• Working knowledge of CAQH, NPPES, PECOS, state Medicaid portals, and other online enrollment platforms
• Experience with online workflow and task-management systems, such as Monday.com
• Multi-state enrollment experience preferred
• Experience supporting a hospital-based or multi-location medical group preferred
• Ability to research payer requirements and develop clear SOPs and workflows
• Highly organized, with the ability to manage multiple applications, deadlines, and priorities
• Critical and proactive thinker who can identify problems and develop practical solutions
• Strong follow-up, problem-solving, research, and communication skills
• Ability to provide concise and accurate updates to leadership
• High attention to detail, accountability, and ability to work independently
• Proficiency with Microsoft Excel and shared document systems

Work Environment

• Onsite Monday through Friday
• Fast-paced, deadline-driven environment
• Frequent coordination with payers, providers, leadership, and internal teams
• Requires independent follow-up and management of multiple priorities

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