Provider Enrollment Specialist

To clear existing enrollment backlogs and streamline payer application workflows, the part-time contract Provider Enrollment Specialist will manage the end-to-end credentialing process, working directly with Managed Care Organizations (MCOs) and state Medicaid programs while navigating complex payer portals. Key responsibilities Executing initial enrollment applications and re-credentialing packets with commercial and government healthcare payers Maintaining and attesting CAQH profiles, NPI data, and Tax Identification Number (TIN) attachments to prevent coverage lapses Tracking pending enrollment applications with MCOs and health plans to expedite processing and secure official effective dates Required qualifications One to three years of experience in healthcare provider credentialing, payer enrollment, or managed care onboarding High school diploma or GED Demonstrated proficiency with payer enrollment portals like Availity, PECOS, and state Medicaid systems Deep understanding of payer-specific credentialing rules, state licensing standards, and enrollment timelines Strong analytical skills to identify missing documentation and resolve enrollment delays independently