Remote Payor Enrollment & Credentialing Specialist

Cone Health Medical Group; United States; Remote; USD 55,000 - 75,000; Full time

Job summary

Cone Health Medical Group is hiring a Payor Enrollment Specialist to manage enrollment, credentialing, and re-credentialing of providers with government and managed care plans. This remote role supports the practitioner network, tracking documentation and data to ensure accessibility of care.

The ideal candidate has 2 years in medical administrative support, proficiency with Excel, and familiarity with credentialing processes. Preference for healthcare insurance/credentialing experience.

Qualifications

• Required: High school diploma or equivalent.
• Required: 2 years' experience in administrative support functions in a physician practice.
• Proficient with Microsoft Excel.
• Preferred: 2 years working experience with insurance, managed care, or medical staff credentialing.

Responsibilities

• Enrolls system-wide health physician and non-physician practitioners in government and managed care plans.
• Maintains and updates credentialing system with effective dates, deadlines and credentials.
• Updates licensure and certification requirements for credentialing applications.
• Ensures CMS and state requirements are documented and tracked for compliance.
• Tracks credentialing documents and ensures timely renewals for all providers.
• Performs data entry into CMS database and responds to enrollment inquiries.

Skills

Administrative support

Education

High school diploma or equivalent

Tools

Microsoft Excel

Job description

Cone Health Medical Group is hiring a Payor Enrollment Specialist to manage enrollment, credentialing, and re-credentialing of providers with government and managed care plans. This remote role supports the practitioner network, tracking documentation and data to ensure accessibility of care.

The ideal candidate has 2 years in medical administrative support, proficiency with Excel, and familiarity with credentialing processes. Preference for healthcare insurance/credentialing experience.