Provider Enrollment & Credentialing Specialist

Geode Health Inc.; United States; Remote; USD 32,000 - 34,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

Life insurance

Short and long‑term disability

Paid vacation and holidays

Matching 401k plan

Flexible schedule

State of the art technology

Job summary

Geode Health is a rapidly growing national provider of outpatient mental health services, and is seeking a Provider Enrollment Associate to oversee credentialing, licensure, and payer enrollment tasks. The role focuses on timely enrollment actions and reducing timelines, with strong communication to providers and partners.

Estimated pay range is $23-$25 per hour, with a requirement of 3–5 years in provider enrollment and proficiency in PECOS, CAQH, and Availity.

Qualifications

• Associate degree or equivalent required; Bachelor's preferred.
• 3–5 years in provider enrollment.
• In-depth knowledge of credentialing, licensure, and payer enrollment requirements.
• Experience with PECOS, CAQH, Availity and other payer portals.

Responsibilities

• Act as a liaison to providers as well as vendors to ensure all information required for credentialing, license verification and payer enrollment is obtained in a timely manner
• Provide credentialing and enrollment expertise for the organization
• Leverage expertise to develop third‑party workers’ knowledge base through regular meetings and coaching
• Maintain accuracy of provider database including payer enrollment, licensure, and malpractice information
• Provide regular reporting of any delays in credentialing or enrollment processes
• Responsible for investigating and self‑reporting issues, developing and implementing solutions to address existing issues and identifying processes to mitigate risk
• Assists in resolving payer enrollment related claim denials
• Continually monitor processes and outcomes to ensure established KPI’s for credentialing, licensure and enrollment tasks are met
• Provide feedback to Payer Contracting to ensure payer specific requirements are not only met, but optimized to reduce enrollment timelines
• Ability to learn and document regulations and rules for new states
• Other duties as assigned

Skills

Credentialing knowledge

Payer enrollment

Licensure verification

Communication skills

Customer service experience

Self-starter

Education

Associate degree or equivalent

Tools

PECOS

CAQH

Availity

EDI enrollments

ERA enrollments

EFT enrollments

PowerPoint

Job description

Geode Health is a rapidly growing national provider of outpatient mental health services, and is seeking a Provider Enrollment Associate to oversee credentialing, licensure, and payer enrollment tasks. The role focuses on timely enrollment actions and reducing timelines, with strong communication to providers and partners.

Estimated pay range is $23-$25 per hour, with a requirement of 3–5 years in provider enrollment and proficiency in PECOS, CAQH, and Availity.