Provider Credentialing & Enrollment Expert

RiseMe; Red Bank (NJ); On-site; USD 60,000 - 80,000; Full time

Job summary

RiseMe is seeking a detail-oriented Credentialing Specialist to manage provider credentialing, payer enrollment, and recredentialing. You will ensure timely and accurate credentialing in compliance with regulatory requirements and maintain updated records across systems.

The role requires strong organizational skills, proficient MS Office use, and experience with CAQH, PECOS, NPDB, and credentialing software.

Qualifications

• High school diploma or equivalent.
• Associate degree or higher preferred in related field.
• Experience with provider credentialing, payer enrollment, or healthcare administration is a plus.
• Familiarity with CAQH, PECOS, NPDB, and credentialing software platforms.

Responsibilities

• Coordinate and perform provider credentialing and recredentialing activities.
• Monitor and maintain credentialing documentation and licenses.
• Submit and retrieve NPDB reports and manage payer enrollment applications.
• Maintain credentialing software and databases and ensure timely renewals.
• Communicate status with providers, insurance carriers, and clients.

Skills

Organizational skills

Attention to detail

MS Office

Communication

Education

Associate degree

Tools

CAQH

PECOS

NPDB

Credentialing software

Job description

RiseMe is seeking a detail-oriented Credentialing Specialist to manage provider credentialing, payer enrollment, and recredentialing. You will ensure timely and accurate credentialing in compliance with regulatory requirements and maintain updated records across systems.

The role requires strong organizational skills, proficient MS Office use, and experience with CAQH, PECOS, NPDB, and credentialing software.