Credentialing and Enrollment Specialist (Private Practice exp. req.)
Location: North Carolina - Fully Remote 
Salary: $46,680 - $53,045
Benefits: Medical Insurance, 401k w/ match, Paid Time Off, Paid Holidays, and more
Job Type: Full-Time
Typical Hours: 8:00 AM – 5:00 PM with flexibility, Mon-Fri 
Start Date: ASAP
Sponsorship is not available 

Credentialing and Enrollment Specialist (Private Practice exp. req.) Description

Join our client’s healthcare team as a Credentialing and Enrollment Specialist and play a pivotal role in supporting community-based healthcare facilities in North Carolina. This fully remote opportunity invites you to leverage your expertise in credentialing processes and make a meaningful impact on the efficiency and effectiveness of healthcare services. With a focus on Federally Qualified Health Centers (FQHCs), your knowledge and skills will directly contribute to the betterment of vital healthcare services. This position is ideal for professionals with a minimum of one year of experience in healthcare provider credentialing within the state, particularly those familiar with private practices or nonprofit healthcare clinics. Your dedication to ensuring smooth onboarding and ongoing support for our medical and behavioral health clients will make you an essential part of our team and the broader healthcare community. This role not only offers a competitive salary and comprehensive benefits but also provides a clear pathway to advancement into a Senior Credentialing & Enrollment position as you increase your caseload.

Credentialing and Enrollment Specialist (Private Practice exp. req.)  Responsibilities

•    Act as the primary contact for client accounts, offering expert guidance and support
•    Independently manage the full spectrum of credentialing and enrollment processes 
•    Analyze and update credentialing statuses to ensure compliance and progress
•    Process Medicare and Medicaid enrollments 
•    Facilitate provider enrollments with various insurance carriers, enhancing provider networks
•    Offer prompt and effective responses to inquiries from insurance companies
•    Keep clients informed about the status of credentialing processes
•    Foster transparency and trust
•    Ensure the integrity of provider information, including up to date CAQH profiles
•    Champion client engagement initiatives and manage enrollment tasks diligently

Credentialing and Enrollment Specialist (Private Practice exp. req.)  Qualifications

•    1+ year of medical credentialing experience in the state of North Carolina required 
•    Credentialing provider files for private practices experience required 
•    Proficiency with credentialing software required
•    Proficiency with Microsoft Office Suite, especially Excel required