Credentialing & Enrollment Specialist

About the role

We’re looking for an experienced and detail-oriented Credentialing and Enrollment Specialist to own all payer enrollment preparation activities for our providers, including radiologists, cardiologists, and optometrists. Working closely with our providers and customer teams, you’ll build and streamline the processes that ensure documentation and applications are complete, accurate, and received in a timely manner. As we scale, you’ll have a direct hand in shaping how our department operates, providing a great opportunity to expand your skill set and grow alongside the company.

Responsibilities

• Complete and track credentialing and payer enrollment applications for all Imagen providers on behalf of customers across commercial, Medicare, and Medicaid plans.
• Partner directly with customers to research their specific payer mix and requirements, ensuring enrollment applications are tailored to their unique timelines and processes.
• Proactively analyze provider documentation and professional history against customer requirements, ensuring application completeness and readiness.
• Establish, refine, and document processes for gathering payer and provider information to enable efficient, accurate, and timely enrollments.
• Input, update, and maintain internal databases and CAQH profiles for Imagen providers to ensure data readiness.
• Communicate regularly with providers, customers, and internal teams to troubleshoot issues, resolve application delays, and ensure seamless credentialing and enrollment.
• Provide regular updates to internal stakeholders regarding enrollment progress, risks, and overall project timelines.
• Support audits and compliance reviews by ensuring documentation and records are accurate, up to date, and easily accessible.

Qualifications

• An associate’s degree and/or bachelor’s degree.
• 3+ years of payer enrollment/credentialing experience; experience within a radiology department or practice is a strong plus.
• Direct experience managing CAQH profiles and utilizing credentialing and enrollment platforms; experience with CredflowAI is a strong plus.
• Experience working with radiologists and/or other specialists across diverse healthcare environments, e.g. health systems, hospitals, outpatient clinics, etc.
• Highly organized and proactive self-starter with strong attention to detail and effective communication skills.
• Certified Provider Enrollment Specialist (CPES) and/or Certified Provider Credentialing Specialist (CPCS) certification highly preferred.

Pay

The hourly rate for the position is between $31.25 - $35.00, plus benefits. Please note that the range is a guideline, and individual total compensation will vary based on factors such as qualifications, skill level, competencies, and work location.