Credentialing & Enrollment Specialist

About the role

Matter Health is seeking an experienced Credentialing & Enrollment Specialist to join our growing team. In this role, you will manage the credentialing, enrollment, and ongoing maintenance of our physicians and advanced practice providers across multiple markets. As a key member of our Credentialing & Enrollment team, you will ensure providers are credentialed, enrolled, and prepared to deliver care. You will collaborate closely with Clinical Operations, Revenue Cycle, Compliance, Human Resources, and external payer organizations.

Responsibilities

• Manage all aspects of provider credentialing, recredentialing, and payer enrollment activities from start to finish
• Prepare, submit, monitor, and maintain Medicare, Medicaid, and commercial payer enrollment applications
• Maintain provider records in CAQH, PECOS, NPPES, and other relevant information systems
• Track credentialing and enrollment timelines to ensure providers are approved and ready to practice
• Collaborate closely with Clinical Operations, Compliance, Revenue Cycle, HR, and external organizations throughout the credentialing process
• Maintain accurate provider records and organize credentialing documentation
• Monitor application status and proactively resolve credentialing and enrollment issues
• Ensure compliance with internal policies, regulatory requirements, and payer guidelines
• Identify and implement opportunities to improve credentialing workflows, documentation, and operational efficiency
• Support organizational growth by credentialing providers across new and existing markets

Qualifications

• 3+ years of provider credentialing and payer enrollment experience preferred
• Demonstrated experience independently managing credentialing and enrollment from application to approval
• Working knowledge of Medicare, Medicaid, and commercial payer enrollment processes
• Experience using CAQH, PECOS, NPPES, Availity, and payer enrollment portals
• Strong understanding of credentialing documentation requirements and provider lifecycle management
• Accurate organizational skills with the ability to manage multiple providers and deadlines simultaneously
• Meticulous attention to detail and a commitment to accuracy
• Exceptional written and verbal communication skills
• Ability to work independently while collaborating across multiple departments
• Proficiency with Microsoft Office, including Excel

PREFERRED QUALIFICATIONS

• Experience within value-based care, primary care, physician groups, or Medicare Advantage organizations
• Experience supporting multi-state credentialing and enrollment
• Familiarity with delegated credentialing programs
• Experience working with advanced practice providers and physicians
• Knowledge of credentialing software and provider database management
• Process improvement or workflow optimization experience