Account Rep, Non-Delegated Healthcare Provider Credentialing & Enrollment

Remote Full-time
Account Representative, Credentialing & Enrollment (non-delegated, Provider-side exp. req.)
Location: Remote – must live in the United States
Salary: $44,000 - $54,000 + Benefits
Benefits: Health Insurance, 401k w/ match, Paid Holidays, Paid Time Off
Job Type: Full-Time | 100% Remote
Typical Hours: 8:00 AM – 5:00 PM with flexibility, Mon-Fri
Start Date: ASAP
Sponsorship is not available

Account Representative, Healthcare Credentialing & Enrollment Description

Join our client’s mission-driven healthcare team and play a key role in supporting community-based clinics across 20 US states. This fully remote position focuses on credentialing and enrollment for Federally Qualified Health Centers (FQHCs), and other nonprofit and private practice healthcare providers. As an Account Representative, you’ll ensure a smooth onboarding experience while managing financial credentialing and payer enrollment, providing ongoing support for both medical and behavioral health providers/clients. This is a great opportunity to directly contribute to improving access to essential healthcare services in underserved communities, with an organization that provides a clear pathway to advancement as your caseload increases.

Account Representative, Healthcare Credentialing & Enrollment Responsibilities
• Act as the primary contact for assigned accounts
• Offer expert guidance and support to clients with regular progress meetings
• Independently manage the full spectrum of financial 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 the credentialing processes
• Ensure the integrity of provider information, including up to date CAQH profiles
• Champion client engagement initiatives and manage enrollment tasks diligently

Account Representative, Healthcare Credentialing & Enrollment Qualifications
• Non-delegated credentialing & provider enrollment for healthcare facilities required
• Experience completing and submitting enrollment applications for billable providers required
• Knowledge of credentialing processes for Medicare, Medicaid, and commercial payers required
• Experience working with nonprofit clinics, FQHCs, and/or private practices required
• Proficiency with credentialing software, MS Office, specifically Excel, required

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Job Type: Full-time

Pay: $44,000.00 - $54,000.00 per year

Benefits:
• 401(k)
• Health insurance
• Paid time off

Application Question(s):
• Which company or positions listed on your resume is your provider-side non-delegated credentialing & enrollment experience for facilities/healthcare providers?
• What billable provider-types have you completed enrollments for?
• The salary range is $44,000 - $54,000 + Benefits. Is that within an acceptable range for you?

Education:
• High school or equivalent (Required)

Experience:
• provider-side non-delegated credentialing & enrollment : 1 year (Required)
• submitting individual provider applications to each payers’ : 1 year (Required)
• working w/ non-profit clinics, FQHCs, /or private practices : 1 year (Required)
• Medicare, Medicaid & commercial payers credentialing : 1 year (Required)
• credentialing software and MS Excel: 1 year (Required)

Work Location: Remote

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