Provider Enrollment & Credentialing Specialist

Socket.dev; United States; Remote; USD 52,000 - 68,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Paid Time Off

401(k) with company match

Referral Program

Payactiv

Job summary

Ennoble Care is seeking a Full-Time Credentialing Specialist to manage provider enrollment applications and related link letters across multiple payer networks. You will coordinate with providers and internal teams to ensure enrollment accuracy, timely revalidations, CAQH maintenance, and issue resolution to protect revenue.

The role requires 3+ years in provider enrollment, strong regulatory knowledge, and proficiency with Microsoft Office and Modio Health.

Qualifications

• Minimum 3 years’ experience in provider enrollment.
• Knowledge of government and commercial payer enrollment processes.
• Proficient in Microsoft Office applications.
• Preferred experience with Modio Health.
• Detail oriented, organized and able to multitask.
• Strong interpersonal and organizational skills with excellent customer service.
• Able to work in a fast-paced, acquisitional environment.
• Represents the organization in a positive and professional manner.

Responsibilities

• Prepare new and existing provider enrollment applications and/or written link letters.
• Create and submit new group enrollment applications when contracts are executed.
• Follow up timely with payers on submitted applications/letters for approval notices.
• Ensure timely revalidation of all providers and groups.
• Communicate with providers and other team members to resolve payer issues and confirm participating status.
• Manage all documentation in an organized manner and update Modio.
• Track all provider licensure and communicate with provider prior to expiration.
• Complete, update and maintain CAQH profiles for providers.
• Identify and communicate any potential enrollment issues that could result in loss of revenue.
• Establish relationships and maintain communication with provider representatives.
• Set up provider portals and maintain access for team members as needed.
• Participate in team meetings and communications.
• Perform specific assignments as directed by the Revenue Cycle Director.

Skills

Regulatory knowledge

payer enrollment knowledge

Provider enrollment experience

Detail oriented

Multitasking

Interpersonal skills

Organizational skills

Customer service

Fast-paced environment

Professionalism

Enrollment teamwork

Tools

Modio Health

Microsoft Office

Job description

Ennoble Care is seeking a Full-Time Credentialing Specialist to manage provider enrollment applications and related link letters across multiple payer networks. You will coordinate with providers and internal teams to ensure enrollment accuracy, timely revalidations, CAQH maintenance, and issue resolution to protect revenue.

The role requires 3+ years in provider enrollment, strong regulatory knowledge, and proficiency with Microsoft Office and Modio Health.