Credentialing Specialist / Provider Enrollment Specialist

About the role

This is a credentialing and provider enrollment role focused on payer applications, CAQH, PECOS, Medicaid managed care, commercial payer panels, revalidations, rosters, effective dates, and clean tracking.

Responsibilities

• Manage initial credentialing and payer enrollment for new clinicians across commercial, Medicare, and Medicaid managed care plans
• Maintain CAQH profiles, NPPES/NPI records, PECOS enrollments, payer applications, and revalidations
• Track licenses, malpractice coverage, certifications, effective dates, and expirations
• Maintain accurate payer rosters and group/individual linkages across our office locations
• Follow up persistently with payers on pending applications, missing items, effective dates, and enrollment discrepancies
• Cook with billing so claims are not submitted before payer effective dates
• Keep clean, auditable records of every application, effective date, payer communication, and follow-up step
• Improve the credentialing tracker and written process as the practice grows

Requirements

• 1+ years of credentialing, provider enrollment, payer enrollment, or healthcare administrative experience
• Hands-on familiarity with CAQH and payer enrollment workflows
• Strong organizational habits: you build trackers, use follow-up dates, and do not rely on memory
• Comfort following up with payers by phone, portal, and email
• Careful attention to names, NPIs, tax IDs, locations, effective dates, payer requirements, and documentation
• Comfort handling PHI and sensitive clinician/practice information
• Clear written communication and clean recordkeeping

Qualifications

• Behavioral health, outpatient specialty, or group practice credentialing experience
• PECOS / Medicare enrollment experience
• Florida Medicaid or Medicaid managed care experience
• Commercial behavioral health payer experience
• Experience maintaining payer rosters across multiple office locations

Skills

Not specified

Benefits

• Employer-subsidized health insurance
• Employer-paid dental, vision, and group life insurance
• 13 days of PTO in your first year; 26 days annually thereafter
• 401(k) with company match
• Opportunities for continuing education and skill development
• Hybrid schedule based out of one of our Broward offices: Fort Lauderdale, Davie, or Coral Springs
• A defined career ladder: Credentialing Specialist to Senior Credentialing Specialist
• Promotions are real title-and-pay moves

Pay

$18–23/hour, based on experience

Schedule

Hybrid schedule based out of one of our Broward offices: Fort Lauderdale, Davie, or Coral Springs