Physician Credentialing & Enrollment Specialist

Critical Care Pulmonary & Sleep Associates; Lakewood (CO); On-site; USD 30,000 - 47,000; Full time

Benefits offered by this job

Medical benefits

Dental and vision benefits

PTO and holidays

401k plan

Life and AD&D

Job summary

Critical Care, Pulmonary and Sleep Associates seeks a Physician Enrollment & Credentialing Specialist to manage provider credentialing, enrollment, appointment, and privileging with commercial payers and government programs in the Denver metro area.

You will support revenue cycle operations by researching and appealing denials, maintaining provider records, and ensuring regulatory compliance. The role requires at least two years of credentialing experience and EPIC Resolute billing familiarity.

Qualifications

• Minimum of two (2) years of credentialing or payer enrollment experience.
• Experience with hospital credentialing and privileging strongly preferred.
• Experience researching, appealing, and resolving insurance claim denials preferred.
• Working knowledge of medical terminology, payer guidelines, and healthcare reimbursement methodologies.
• Proficient in Microsoft Outlook, Word, Excel; strong communication skills.

Responsibilities

• Credentialing, enrollment, appointment, and privileging for providers with commercial and government payers and hospitals.
• Manage ongoing credentialing maintenance and compliance with licenses and certifications.
• Coordinate provider onboarding related to credentialing and privileging.
• Maintain credentialing records and monitor payer portals and CAQH.
• Review denials, research appeals, and support revenue cycle improvements.

Skills

Provider credentialing

Payer enrollment

Denials management

Medical billing support

Communication skills

Multitasking

Independent work

Education

High School Diploma or GED

Tools

EPIC Resolute Professional Billing

Job description

Critical Care, Pulmonary and Sleep Associates seeks a Physician Enrollment & Credentialing Specialist to manage provider credentialing, enrollment, appointment, and privileging with commercial payers and government programs in the Denver metro area.

You will support revenue cycle operations by researching and appealing denials, maintaining provider records, and ensuring regulatory compliance. The role requires at least two years of credentialing experience and EPIC Resolute billing familiarity.