Credentialing Specialist: Provider Enrollment & Compliance

Foothills Neurology P C; Phoenix (AZ); On-site; USD 48,000 - 62,000; Full time

Job summary

Foothills Neurology P C is seeking a Credentialing Specialist to manage provider credentialing, payer enrollment, and re-credentialing across the Billing and Finance Department. This role ensures physicians, nurse practitioners, and physician assistants are accurately credentialed and enrolled with contracted plans to maintain uninterrupted reimbursement and compliance.

The ideal candidate is detail-oriented, self-motivated, and able to manage multiple credentialing timelines while maintaining

Qualifications

• Minimum of 2 years of credentialing and/or payer enrollment experience in healthcare.
• Knowledge of insurance payer processes and CAQH/NPPES/PECOS systems.
• Familiarity with CMS, commercial insurance, and Medicaid enrollment processes preferred.

Responsibilities

• Prepare and submit credentialing and payer enrollment applications for providers and locations.
• Maintain up-to-date provider records including licenses, DEA, NPI, board certifications, and malpractice insurance.
• Track expirations, renewals, and re-attestation deadlines for compliance.
• Conduct primary source verification and maintain digital credentialing files.
• Communicate with payers, providers, and internal departments to resolve enrollment issues.
• Coordinate with HR during provider onboarding and terminations to ensure timely credentialing.
• Collaborate with billing and revenue cycle teams to align enrollment with payer rosters.
• Prepare status reports on pending applications and expirations for leadership.
• Support audits and payer correspondence; stay updated on regulatory changes.

Skills

Attention to detail

Organization & deadline management

Written and verbal communication

Independent work

Microsoft Office (Word, Excel, Outlook

Education

High school diploma or equivalent

Associate's or Bachelor's degree preferred

Tools

CAQH

NPPES/PECOS

Credentialing software

Job description

Foothills Neurology P C is seeking a Credentialing Specialist to manage provider credentialing, payer enrollment, and re-credentialing across the Billing and Finance Department. This role ensures physicians, nurse practitioners, and physician assistants are accurately credentialed and enrolled with contracted plans to maintain uninterrupted reimbursement and compliance.

The ideal candidate is detail-oriented, self-motivated, and able to manage multiple credentialing timelines while maintaining