Healthcare Credentialing & Enrollment Specialist

Noble Community Clinics; Stevens Point (WI); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

PTO 20 days

8 paid holidays

401(k) with employer match

Medical, dental, and vision insurance

Short- and long-term disability and生命险

Job summary

Noble Community Clinics in Stevens Point, WI is seeking a Credentialing Specialist to manage provider enrollment, payer contracting, revalidation, and credentialing workflows. You will ensure enrollment accuracy and timely completion, maintain CAQH proxy access, and track renewals to prevent lapses.

This role collaborates with providers, internal departments, insurance payers, and external partners to resolve enrollment issues, support HIPAA compliance, and uphold the standards required of

Qualifications

• High school diploma or equivalent required.
• Experience in payer enrollment, credentialing, or payer contracting preferred.
• Strong computer skills, including Microsoft Office.
• Excellent organizational and communication skills.
• Ability to meet deadlines and manage multiple tasks.
• CPR certification within six months of hire.

Responsibilities

• Manage provider enrollment with applicable payers and clearinghouses.
• Utilize Credential Stream to maintain provider enrollment data and demographics.
• Maintain CAQH proxy access for providers.
• Track renewals and expirations to prevent enrollment lapses.
• Coordinate payer revalidations, renewals, and enrollment updates.
• Develop relationships with payer contacts and internal departments.
• Resolve enrollment-related denials and appeals; escalate as needed.
• Ensure HIPAA compliance and protect patient confidentiality.

Skills

Organizational skills

Attention to detail

Analytical thinking

Time management

Communication skills

CAQH/credentialing knowledge

HIPAA compliance

Education

High school diploma or equivalent

Tools

Microsoft Office

Credentialing software (CAQH)

Job description

Noble Community Clinics in Stevens Point, WI is seeking a Credentialing Specialist to manage provider enrollment, payer contracting, revalidation, and credentialing workflows. You will ensure enrollment accuracy and timely completion, maintain CAQH proxy access, and track renewals to prevent lapses.

This role collaborates with providers, internal departments, insurance payers, and external partners to resolve enrollment issues, support HIPAA compliance, and uphold the standards required of