Senior Provider Enrollment & Credentialing Specialist

Overview & Highlights

• Position: Senior Provider Enrollment & Credentialing Specialist
• Location: Remote
• Schedule: Full-time; flexible scheduling options available, including 4x10s or 5x8s
• Compensation: $75,000 base salary
• Bonus: Annual bonus based on performance and profit sharing; additional bonus opportunity for bringing a book of business or qualified referrals
• Benefits: Unlimited PTO; no traditional benefits package currently offered
• Work Setting: Boutique national provider enrollment and credentialing firm with 27+ years in business
• Remote / Hybrid / On-Site Status: Fully remote
• Employment Type: Open to W2 or 1099 arrangement

About the Opportunity / A Day in the Life

This is a senior-level provider enrollment and credentialing role for someone who already knows the work, understands the provider-side process, and can step into a high-accountability environment with confidence. The ideal candidate will be comfortable managing credentialing and enrollment activities from start to finish for provider organizations, clinics, medical groups, and consulting clients.

In this role, you will handle provider enrollment workflows, credentialing files, payer applications, revalidations, updates, follow-ups, documentation, and client communication with a high degree of accuracy. You will be expected to prioritize competing deadlines, manage volume without sacrificing precision, and keep enrollment activity moving forward across multiple clients and payers.

This is not a training role. The firm is looking for someone who can hit the ground running, operate independently, ask smart questions when needed, and bring a strategic approach to problem-solving. At the same time, this is a strong opportunity for an experienced credentialing and enrollment professional who wants to keep growing. With 27+ years in business and a national client base, the organization offers meaningful exposure to complex provider enrollment work and long-term advancement potential.

Why This Role Stands Out

• Fully remote role with flexible full-time scheduling options
• Strong base compensation with annual performance/profit-sharing bonus potential
• Additional bonus opportunity for bringing a book of business or qualified referrals
• Opportunity to join a boutique national firm with more than 27 years of industry experience
• Senior-level role with room for advancement and increased ownership
• Exposure to complex provider enrollment and credentialing work across multiple provider organizations and payer environments

What We’re Looking For

• A highly experienced provider enrollment and credentialing professional who can work independently from day one
• Someone with direct experience supporting provider organizations, clinics, medical groups, or consulting clients
• A strong, confident communicator who can manage client expectations and payer follow-up professionally
• A highly organized specialist who can handle volume, deadlines, details, and documentation with precision
• A strategic thinker who understands how to move enrollment issues forward instead of simply tracking tasks
• Someone who takes ownership of their work and understands the operational impact of credentialing and enrollment accuracy

Job Duties & Responsibilities

• Manage provider enrollment and credentialing activities for provider organizations, clinics, medical groups, and consulting clients
• Prepare, review, submit, and track payer enrollment applications, credentialing files, revalidations, updates, and related documentation
• Work with commercial payers, government payers, payer portals, CAQH, PECOS/NPPES, and other enrollment tools as applicable
• Maintain accurate provider data, enrollment status updates, supporting documents, and credentialing records
• Communicate directly with clients, providers, payers, and internal leadership regarding enrollment status, missing information, deadlines, and next steps
• Monitor application progress, follow up with payers, resolve delays, and escalate issues when needed
• Review provider files for completeness, accuracy, compliance, and readiness prior to submission
• Manage multiple client priorities while maintaining strong documentation standards and clear communication
• Support credentialing, recredentialing, payer enrollment, demographic updates, terminations, and maintenance workflows
• Identify process gaps, payer-specific issues, and opportunities to improve turnaround times or client outcomes
• Maintain confidentiality and follow HIPAA, payer, and client-specific documentation expectations
• Represent the firm professionally in all client and payer interactions

Required Qualifications

• Significant hands-on experience in provider enrollment and credentialing
• Must have experience working directly with provider organizations, clinics, medical groups, or consulting clients
• Must understand the provider-side enrollment and credentialing process, not only payer-side credentialing operations
• Ability to independently manage enrollment and credentialing workflows from start to finish
• Experience with payer applications, payer portals, CAQH, PECOS/NPPES, revalidations, demographic updates, and follow-up processes as applicable
• Strong written and verbal communication skills with the ability to interact professionally with clients, providers, payers, and leadership
• Excellent organization, prioritization, documentation, and follow-through skills
• Ability to work remotely with a high level of accountability, confidentiality, and independence
• Must be able to work full-time on a flexible schedule, with options such as 4x10s or 5x8s

Preferred Background

• Experience in a consulting, outsourced credentialing, provider enrollment firm, medical group, MSO, or multi-specialty provider organization
• Experience managing multiple clients, provider groups, or payer relationships at one time
• Strong knowledge of commercial payer, Medicare, Medicaid, and government enrollment workflows
• Experience resolving enrollment delays, payer discrepancies, application issues, and provider data problems
• Familiarity with credentialing documentation, licensing, malpractice coverage, board certifications, NPIs, taxonomy, W-9s, EFT/ERA forms, and supporting enrollment materials
• Existing provider organization relationships, referral sources, or book of business a plus

This Role Is Likely a Fit If You…

• Are highly professional, organized, independent, and strategic in how you work
• Know provider enrollment and credentialing well enough to manage complex workflows without basic training
• Enjoy remote work and can stay productive, responsive, and accountable without daily oversight
• Can balance speed, accuracy, and client service in a volume-driven environment
• Communicate clearly and confidently with providers, administrators, payers, and leadership
• Like being part of a specialized firm where your expertise is valued and your growth can continue

This Role May Not Be a Fit If You…

• Need training on the fundamentals of provider enrollment or credentialing
• Have only worked on the payer side and have not supported provider organizations directly
• Struggle to prioritize competing deadlines, payer follow-ups, and client requests
• Have difficulty maintaining accuracy while managing a high volume of work
• Prefer a heavily structured environment where every task is assigned step by step
• Are uncomfortable with remote accountability, independent problem-solving, or client-facing communication

Why Join Us

This is an opportunity to join a boutique national firm with more than 27 years of experience supporting provider enrollment and credentialing needs. The work is detailed, fast-moving, and important. Clients rely on accurate enrollment, strong follow-up, and knowledgeable guidance to keep provider operations moving and revenue flowing.

For the right person, this role offers remote flexibility, senior-level ownership, bonus potential, and a path for advancement. If you are a confident provider enrollment and credentialing professional who can step in, take ownership, and deliver high-quality work with precision, we encourage you to apply.

Requirements

• 5+ Years Provider Enrollment & Credentialing Experience (Commercial, Medicaid, Medicare)
• Experience with CAQH, payer portals, and common enrollment workflows
• Experience supporting provider credentialing and enrollment from the provider, clinic, healthcare organization, or consulting side; experience limited solely to payer-side credentialing will not meet this requirement.
• Comfortable managing multiple providers, groups, and multi-state enrollments simultaneously