Strategic Provider Enrollment & Credentialing Specialist

Paycom - ATS; Town of Texas (WI); On-site; USD 55,000 - 75,000; Full time

Job summary

Paycom - ATS is seeking a Provider Enrollment Specialist to coordinate enrollment, credentialing support, and payer participation for physicians and providers. This role ensures timely enrollment with Medicare, AHCCCS, and commercial payers, maintaining accurate provider records and supporting compliant billing.

You will collaborate with medical staff, revenue cycle, and compliance to ensure credentialing and enrollment remain current, audit-ready, and aligned with CMS and HIPAA standards.

Qualifications

• High School Diploma or GED is required.
• 1–2 years of provider enrollment, credentialing, or payer relations experience.
• Basic knowledge of Medicare, Medicaid/AHCCCS, and commercial payer requirements.
• Familiarity with CAQH, PECOS, NPPES, and payer enrollment portals preferred.

Responsibilities

• Manage provider enrollment with Medicare, AHCCCS, commercial plans, and other payers.
• Prepare, complete, and submit enrollment applications accurately and on time.
• Coordinate provider revalidations, reenrollments, and updates to ensure participation.
• Maintain provider demographic information across payer and regulatory databases.
• Monitor application status and follow up with payers to resolve delays or denials.
• Liaise between providers, hospital departments, and insurance carriers on enrollment matters.
• Ensure enrollment data is audit-ready with licenses, registrations, and coverage.
• Assist onboarding by coordinating enrollment for timely billing readiness.

Skills

Attention to detail

Communication

Regulatory compliance

Education

High School Diploma or GED

Tools

CAQH

PECOS

NPPES

Job description

Paycom - ATS is seeking a Provider Enrollment Specialist to coordinate enrollment, credentialing support, and payer participation for physicians and providers. This role ensures timely enrollment with Medicare, AHCCCS, and commercial payers, maintaining accurate provider records and supporting compliant billing.

You will collaborate with medical staff, revenue cycle, and compliance to ensure credentialing and enrollment remain current, audit-ready, and aligned with CMS and HIPAA standards.