Provider/Payer Enrollment & Credentialing Administrator

Job Title: Provider/Payer Enrollment & Credentialing Administrator

Job Type: Full-Time Remote or On-Site

Location: United States

Salary Range: $50,000 – $70,000 per year (or $25 – $35/hour) depending on experience

Job Summary:

We are seeking an experienced and organized Provider/Payer Enrollment & Credentialing Administrator to manage and maintain accurate credentialing and enrollment of healthcare providers with various payers and networks. This position ensures timely processing and compliance with industry standards, payer requirements, and organizational policies.

Key Responsibilities:

Prepare and submit credentialing and re-credentialing applications for healthcare providers

Manage payer enrollment for Medicare, Medicaid, commercial insurers, and managed care organizations

Track and maintain credentialing statuses and expiration dates using credentialing software

Follow up with payers to ensure applications are processed within set timeframes

Maintain up-to-date provider records and documentation (licenses, certifications, malpractice insurance, etc.)

Assist in audits and ensure compliance with state, federal, and payer requirements

Respond to internal and external inquiries regarding credentialing and enrollment status

Collaborate with providers, billing teams, HR, and compliance departments

Qualifications:

High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred

2+ years of experience in credentialing, provider enrollment, or medical administration

Knowledge of CAQH, PECOS, NPPES, and payer-specific systems

Familiarity with Medicare/Medicaid and commercial payer guidelines

Strong organizational and time-management skills

Excellent verbal and written communication

Proficiency in credentialing software and Microsoft Office Suite

Ability to handle confidential information with discretion

Preferred Skills:

Certification in Medical Staff Services (CPCS or CPMSM) a plus

Experience working in a healthcare group practice, hospital, or billing service

Knowledge of medical terminology and insurance billing basics

Benefits:

Competitive salary ($25–$35/hour or equivalent salary range)

Health, dental, and vision insurance

Paid time off and holidays

Flexible work schedule

Remote work options

Career development opportunities

Apply today to join a team that supports provider operations and ensures seamless payer enrollment and credentialing processes.