Practitioner Mgmt Coord (US)

Millennium Physician Group; Cerritos (CA); On-site; USD 33,000 - 60,000; Full time

Job summary

Millennium Physician Group seeks a Credentialing & Enrollment Specialist to coordinate and maintain provider credentialing and enrollment activities, ensuring compliance with NCQA, CMS, and state regulations. You will manage inventories, review applications, and communicate decisions to providers and internal partners.

The role requires strong organization, attention to detail, proficiency in Microsoft Excel, and excellent written and verbal communication skills, supporting collaboration with

Qualifications

• High school diploma required; associate/bachelor preferred.
• Minimum of 2 years in healthcare credentialing/enrollment.
• Experience with health plans, provider groups, or managed care preferred.
• Knowledge of credentialing, recredentialing, and enrollment processes.

Responsibilities

• Coordinate initial credentialing and recredentialing inventories.
• Review applications for completeness and accuracy.
• Outreach to providers for missing documentation.
• Track credentialing status in systems and reports.
• Communicate approvals, denials, and updates to stakeholders.
• Support provider enrollment with government and commercial payers.
• Maintain accurate provider records and databases.
• Respond to inquiries from shared mailboxes in a timely manner.
• Collaborate with partners to resolve credentialing issues.
• Prepare Excel tracking logs for audits.
• Ensure NCQA, CMS, and state regulatory compliance.
• Assist with credentialing audits and data validation.
• Escalate complex issues and aging inventory when needed.

Skills

Excel proficiency

Attention to detail

Organizational skills

Communication skills

Multitasking

Cross-functional collaboration

Customer service

Education

High school diploma

Associate's degree preferred

Bachelor's degree preferred

Tools

Microsoft Excel

Job description

Job Description Summary

The Credentialing & Enrollment Specialist is responsible for coordinating and maintaining provider credentialing and enrollment activities to ensure compliance with organizational, regulatory, and health plan requirements. This role manages initial credentialing and recredentialing inventories, supports provider enrollment processes, conducts outreach for missing documentation, communicates credentialing decisions, and serves as a liaison between providers, network partners, and internal stakeholders. The position requires strong organizational skills, attention to detail, proficiency in Microsoft Excel, and excellent written and verbal communication skills.

How Will You Make An Impact & Requirements

• Manage and maintain assigned initial credentialing and recredentialing inventories to ensure timely completion and compliance with established turnaround times.
• Review credentialing and enrollment applications for completeness and accuracy.
• Conduct outreach to providers, provider groups, and internal stakeholders to obtain missing or required documentation.
• Track and monitor credentialing and enrollment status through various systems and reports.
• Communicate credentialing approvals, denials, and status updates to providers and internal business partners.
• Support provider enrollment activities with government and commercial payers.
• Maintain accurate provider records, files, and databases.
• Monitor shared departmental email inboxes and respond to inquiries in a timely and professional manner.
• Collaborate with network partners, health plans, provider offices, delegated entities, and internal departments to resolve credentialing and enrollment issues.
• Prepare and maintain Excel spreadsheets, tracking logs, and reports for operational and audit purposes.
• Ensure compliance with NCQA, CMS, state regulatory, and organizational credentialing requirements.
• Assist with credentialing audits, data validation, and special projects as assigned.
• Escalate complex issues and aging inventory items as appropriate.

Required Education And Experience

• High school diploma or equivalent required; Associate's or Bachelor's degree preferred.
• Minimum of 2 years of healthcare credentialing and/or provider enrollment experience.
• Experience working with health plans, provider groups, or managed care organizations preferred.
• Knowledge of provider credentialing, recredentialing, and enrollment processes.

Knowledge, Skills, And Abilities

• Strong proficiency in Microsoft Excel, including sorting, filtering, reporting, and data management.
• Excellent verbal and written communication skills.
• Strong attention to detail and organizational skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
• Experience maintaining shared mailboxes and managing high-volume communications.
• Ability to work independently and collaboratively with cross-functional teams.
• Customer service oriented with strong problem-solving skills.
• Knowledge of credentialing regulations, accreditation standards, and provider data management preferred.

Preferred Experience

• Experience with NCQA credentialing standards.
• Experience with provider enrollment systems, CAQH, PECOS, NPPES, Availity, and state Medicaid enrollment portals.
• Experience supporting delegated credentialing or managed care network operations.

Compensation Range

$24.20 to $43.56

The anticipated base salary range represents the Company's good-faith estimate of the compensation it reasonably expects to pay for this position at the time of posting. Actual compensation will be determined based on factors including experience, skills, qualifications, geographic location, internal equity, and business needs.