Healthcare Enrollment & Credentialing Specialist

Petaluma Health Center; Petaluma (CA); On-site; USD 52,000 - 72,000; Full time

Benefits offered by this job

Medical Insurance (deductible paid by/

Vision Insurance

401K Matching

Paid Time Off

Flexible Spending Account

Life Insurance

Long Term Disability

Employee Assistance Program

Job summary

Petaluma Health Center is seeking an Enrollment Specialist to maintain provider, facility, and payer enrollments, supporting uninterrupted reimbursement and regulatory compliance.

You will coordinate enrollment applications, revalidations, changes, payer communications, and credentialing support, working closely with providers, Human Resources, Revenue Cycle, Finance, and payer organizations to keep enrollment data accurate and current.

Qualifications

• Knowledge of healthcare provider enrollment, payer enrollment processes, Medicare, Medi-Cal, managed care plans, commercial insurance requirements, and regulatory compliance.
• Demonstrated organizational and analytical skills with the ability to manage multiple enrollment deadlines.
• Effective communication with internal and external stakeholders is essential.

Responsibilities

• Prepare, submit, and track provider and facility enrollment applications.
• Coordinate initial enrollments, revalidations, reactivations, changes of information, and terminations.
• Maintain enrollment records, supporting documentation, and required signatures.
• Monitor application status and follow up with payer organizations until completion.
• Research and resolve enrollment issues or deficiencies to prevent delays.

Skills

Organizational skills

Analytical skills

Communication skills

Multitasking

Education

High school diploma or equivalent

FQHC experience preferred

Epic/OCHIN experience preferred

Tools

PECOS

PAVE

CAQH

NPPES

Job description

Petaluma Health Center is seeking an Enrollment Specialist to maintain provider, facility, and payer enrollments, supporting uninterrupted reimbursement and regulatory compliance.

You will coordinate enrollment applications, revalidations, changes, payer communications, and credentialing support, working closely with providers, Human Resources, Revenue Cycle, Finance, and payer organizations to keep enrollment data accurate and current.