Strategic Payor Credentialing Specialist

Physician and Tactical Healthcare Services, LLC; Cherry Hill Township (NJ); On-site; USD 28,000 - 33,000; Full time

Job summary

PATHS is seeking a Credentialing/Payor Enrollment Specialist to support patients and families in securing health coverage and resolving billing issues. This role ensures HIPAA compliance and accurate documentation across multiple states.

Responsibilities include submitting Medicare/Medicaid and commercial enrollment applications, tracking status, obtaining provider IDs, and liaising with billing to resolve denials. Strong communication and organizational skills are essential.

Qualifications

• Excellent verbal and written communication skills.
• Ability to maintain confidentiality per HIPAA requirements.
• Two years of payor enrollment experience with CAQH and payer portals.

Responsibilities

• Submit initial and re-credentialing payor enrollment applications for Medicare, Medicaid, and commercial enrollment.
• Follow up on application status with payors and obtain provider IDs.
• Serve as liaison between billing and payors to troubleshoot claims denials.
• Maintain documentation and credentialing matrices with attention to detail.

Skills

Communication

Interpersonal skills

HIPAA compliance

Organizational skills

Microsoft Office

EMR familiarity

Payer portals

Education

High school diploma or GED

Post-secondary education preferred

Tools

Microsoft Office Suite

Outlook

Word

Excel

EMR

Payer portals

Job description

PATHS is seeking a Credentialing/Payor Enrollment Specialist to support patients and families in securing health coverage and resolving billing issues. This role ensures HIPAA compliance and accurate documentation across multiple states.

Responsibilities include submitting Medicare/Medicaid and commercial enrollment applications, tracking status, obtaining provider IDs, and liaising with billing to resolve denials. Strong communication and organizational skills are essential.