Provider Credentialing & Enrollment Specialist

Springfield Clinic; Hawthorne Place (IL); On-site; USD 55,000 - 75,000; Full time

Job summary

Springfield Clinic is seeking a Provider Enrollment/Application Specialist to prepare and submit credentialing applications for physicians and locations, coordinating with Payer Relations, Patient Accounting, and Managed Care.

The role requires a bachelor's degree in business or 3–5 years of related experience; strong knowledge of credentialing policies; proficiency in Microsoft Office; and meticulous attention to detail to ensure timely, accurate submissions.

Qualifications

• Bachelor's degree in business or related field, OR 3–5 years of related experience.
• Knowledge of commercial credentialing policies and regulations.
• Familiar with private and commercial insurance including Medicare and Medicaid.
• Proficient with Microsoft Office (Excel, Access, PowerPoint, Word).
• Detail-oriented with high accuracy and strong communication.

Responsibilities

• Manage completion and submission of provider enrollment applications.
• Communicate with Operations Stakeholders and Managed Care plans about status changes.
• Understand payer-specific requirements for enrollment and required docs.
• Maintain enrollment documentation and reporting.
• Retain records of completed enrollment applications.
• Expedite provider forms and gather signatures and docs.
• Update credentialing database and required systems.
• Manage re-credentialing applications with facilities and payers.
• Collaborate with Patient Accounting and Payer Relations to ensure compliance.
• Identify recurring credentialing issues for payer relations meetings.
• Maintain professional relationships with providers and other departments.

Skills

Communication skills

Attention to detail

Multitasking

Time management

Problem solving

Education

Bachelor's degree in business or related field

Tools

Excel

Access

PowerPoint

Word

Job description

Springfield Clinic is seeking a Provider Enrollment/Application Specialist to prepare and submit credentialing applications for physicians and locations, coordinating with Payer Relations, Patient Accounting, and Managed Care.

The role requires a bachelor's degree in business or 3–5 years of related experience; strong knowledge of credentialing policies; proficiency in Microsoft Office; and meticulous attention to detail to ensure timely, accurate submissions.