Credentialing Specialist

About the role

Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. Our board-certified physicians and expert staff are on a mission to improve people’s quality of life by relieving the painful, yet highly treatable symptoms of vein disease—such as varicose veins and heavy, aching legs.

Responsibilities

• Submit and track provider enrollments across Medicare/Medicaid (PECOS) and commercial payers (e.g., Availity) to secure effective dates.
• Identify network expansion opportunities by enrolling providers into additional payer products, plans, and service locations.
• Maintain CAQH attestations and accurate provider data across payer portals and internal credentialing systems.
• Monitor re-validations/re-credentialing and manage expirables to prevent participation lapses.
• Assist with onboarding new providers: gather documents, set up NPI/taxonomy/locations, and coordinate start-date readiness.
• Respond to payer requests, supply additional documentation, and resolve application issues promptly.
• Escalate concerns and complex cases to the Supervisor of Credentialing for timely resolution and participate in special projects as needed.

Requirements

• 2+ years in provider credentialing and/or payer enrollment (physician group, MSO, health plan, or hospital).
• Hands-on with CAQH (attestations/rosters), Medicare PECOS, and payer portals (e.g., Availity).
• Working knowledge of Medicare/Medicaid and commercial enrollment rules.
• Proficient in credentialing systems (e.g., MD-Staff/Cactus) and Excel/Google Sheets.
• Strong data accuracy and documentation habits; able to maintain clean provider records across multiple systems.
• Effective written/verbal communication with payers, providers, and internal stakeholders; escalates issues appropriately.
• Prioritize in a high-volume environment, meet deadlines, and follow SOPs with minimal supervision.
• Self-starter mindset with ownership and follow-through in a remote setting.

Qualifications

• High school diploma or equivalent required.

Skills

• Detail-oriented.
• Process-driven.

Benefits

• Medical, Dental, and Vision Insurance.
• 401(k) with Company Match.
• Paid Time Off (PTO) + Paid Company Holidays.
• Company-Paid Life Insurance.
• Short-Term Disability Insurance.
• Employee Assistance Program (EAP).
• Career Growth & Development Opportunities.