Provider Enrollment & Credentialing Specialist

Physicians' Ally Inc.; Littleton (CO); On-site; USD 50,000 - 70,000; Full time

Benefits offered by this job

Health insurance

Paid time off

401(k) matching

Dental insurance

Flexible schedule

Vision insurance

Job summary

Physicians' Ally is seeking a Credentialing Specialist to join our Colorado team. This role manages provider credentialing, payer enrollment, CAQH maintenance, demographic records, and regulatory activities across U.S. practices.

The position supports physicians and practice administrators, requiring strong attention to detail, organization, and communication, with the ability to manage multiple deadlines. Hybrid in Colorado, full-time or part-time, with benefits including health insurance,

Qualifications

• 2+ years of credentialing, provider enrollment, or healthcare administration experience.
• Working knowledge of CAQH, NPPES, Medicare, Medicaid, and payer portals.
• Proficiency with Microsoft Office and web-based applications.
• Strong organizational, communication, and multitasking skills.
• Detail-oriented with a high level of professionalism and confidentiality.

Responsibilities

• Manage provider credentialing, recredentialing, and CAQH maintenance.
• Prepare and track provider enrollments with commercial and government payers.
• Maintain provider demographics, NPPES records, payer rosters, and directory listings.
• Coordinate Medicare, Medicaid, and state licensure applications and renewals.
• Manage hospital privileging, ASC credentialing, and facility affiliations.
• Monitor credentialing deadlines, provider documentation, and regulatory compliance.
• Research and resolve credentialing, enrollment, and payer-related issues.
• Communicate effectively with providers, payers, hospitals, and regulatory agencies.

Skills

Credentialing

Provider enrollment

CAQH

NPPES

Payer portals

Microsoft Office

Communication

Multitasking

Confidentiality

Tools

Modio

Job description

Benefits

• Health insurance
• Paid time off
• 401(k) matching
• Dental insurance
• Flexible schedule
• Vision insurance

Provider Enrollment & Credentialing Specialist

Location: In-Person/Hybrid

Employment Type: Full-Time or Part-Time

Compensation: Competitive, based on experience

About Physicians' Ally

Physicians' Ally is a nationally recognized healthcare consulting firm that provides physician practices, surgery centers, and healthcare organizations with expert credentialing, provider enrollment, payer contracting, and consulting services. For more than 25 years, we have helped independent medical practices navigate the complexities of payer participation, provider enrollment, and practice growth.

We are seeking a highly organized and detail-oriented Credentialing Specialist to join our growing team. This position is ideal for an individual who enjoys problem solving, managing multiple projects, and serving as a trusted resource for healthcare providers and practice administrators.

Position Summary

The position is posted as full-time, but does not necessarily require 30-40 hours/week. Also posted as fully remote, but if candidate is in Colorado, could be in-person or hybrid. Responsible for managing provider credentialing, payer enrollment, demographic maintenance, and related regulatory activities on behalf of physician practices across the United States. This role requires strong attention to detail, excellent communication skills, and the ability to work independently while managing multiple deadlines and priorities.

Successful candidates will have experience with provider credentialing, CAQH maintenance, Medicare and Medicaid enrollments, payer portals, and healthcare regulatory requirements.

Essential Responsibilities

• Manage provider credentialing, recredentialing, and CAQH maintenance.
• Prepare and track provider enrollments with commercial and government payers.
• Maintain provider demographics, NPPES records, payer rosters, and directory listings.
• Coordinate Medicare, Medicaid, and state licensure applications and renewals.
• Manage hospital privileging, ASC credentialing, and facility affiliations.
• Monitor credentialing deadlines, provider documentation, and regulatory compliance.
• Research and resolve credentialing, enrollment, and payer-related issues.
• Communicate effectively with providers, payers, hospitals, and regulatory agencies.

Qualifications

• 2+ years of credentialing, provider enrollment, or healthcare administration experience.
• Working knowledge of CAQH, NPPES, Medicare, Medicaid, and payer portals.
• Proficiency with Microsoft Office and web-based applications.
• Strong organizational, communication, and multitasking skills.
• Detail-oriented with a high level of professionalism and confidentiality.

Preferred

• CPCS certification.
• Experience with Modio or similar credentialing software.
• Hospital privileging experience.
• Healthcare consulting or multi-specialty practice experience.