Remote Payor Credentialing and Enrollment Specialist

Eating Recovery Center; Denver (CO); Remote; USD 29,000 - 39,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid Time Off

Parental Leave

Retirement benefits

Tuition reimbursement

Job summary

ERC Pathlight is seeking a Payor Credentialing Specialist to support credentialing, enrollment, and re‑credentialing for network physicians and providers in a remote setting. The position follows a hybrid policy for candidates within 35 miles of ZIP code 80230.

The role involves coordinating with payors, submitting applications to Medicare, Medicaid, and commercial carriers, and maintaining audit‑ready records in CAQH, PECOS, and NPPES while ensuring HIPAA compliance.

Qualifications

• Minimum of 3 years of experience in healthcare facility credentialing and physician credentialing (required)
• High school or GED (required)
• Bachelor’s degree in business, healthcare or related field preferred (or equivalent experience)
• Certified Provider Credentialing Specialist (CPCS) or Certified Provider Enrollment Specialist (CPES) preferred

Responsibilities

• Coordinate credentialing, recredentialing, and provider enrollment for physicians, advanced practice providers, and allied health professionals
• Submit credentialing and enrollment applications to Medicare, Medicaid, commercial carriers, and managed care organizations
• Monitor application status, follow up with payors, and resolve deficiencies for timely enrollment
• Verify provider credentials including licensure, education, training, and certifications
• Maintain credentialing databases (MD Staff, CAQH, PECOS, NPPES) and audit-ready files
• Coordinate with providers and internal departments to obtain required documentation
• Generate credentialing reports and support internal/external audits
• Ensure compliance with federal and state regulations, HIPAA, and organizational policies

Skills

Credentialing

Organization

Communication

Multi-tasking

Education

Bachelor’s degree in business, healthcare or related field

Tools

MD Staff

CAQH

PECOS

NPPES

Job description

ERC Pathlight is seeking a Payor Credentialing Specialist to support credentialing, enrollment, and re‑credentialing for network physicians and providers in a remote setting. The position follows a hybrid policy for candidates within 35 miles of ZIP code 80230.

The role involves coordinating with payors, submitting applications to Medicare, Medicaid, and commercial carriers, and maintaining audit‑ready records in CAQH, PECOS, and NPPES while ensuring HIPAA compliance.