Provider Credentialing & Enrollment Specialist

Remote Full-time
It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Summary **This is a part-time, temporary position with the potential to transition into a full-time role** **This is a remote position** We are seeking a detail-oriented Credentialing & Enrollment Specialist to support provider enrollment, revalidation, and ongoing maintenance across multiple payors and states. This role focuses on resolving enrollment issues, reducing denials, and ensuring timely provider participation and reimbursement. Description Credentialing & Enrollment Support Review and resolve enrollment with focus on state-specific requirements. Identify and trend denial patterns to prevent recurrence (e.g., taxonomy mismatches, missing DEA, non-participating providers, admitting privileges). Review Medicaid applications, revalidations, and facility enrollments at both group and individual levels. Support NY ETIN and ETINS processing as required. Roster & Reporting Management Prepare and submit monthly rosters and uploads, including new provider additions and terminations. Manage delegated rosters such as NY-NJ Fidelis and submissions through 3rd party vendor Medallion platform Compliance & Payor Requirements Track and resolve payors pending over 90 days and identify roadblocks. Communication & Administrative Support Manage incoming emails and correspondence and confirm appropriate mail types and follow-up actions. Support telehealth enrollment workflows and system integrations. Assist with administrative tasks, documentation, and audit readiness. Performance & Process Improvement Ensure requests submitted through 3rd party vendor Medallion are timely and accurate. Collaborate with leadership to identify root causes of delays and prevent recurrence. Qualifications Experience minimum two years in provider credentialing and enrollment, including Medicaid/revalidations/ETIN certifications for NY/NJ states Knowledge of CAQH, Application utilizing our 3rd party vendor platform-Medallion Strong attention to detail and analytical skills. Ability to manage multiple priorities in a fast-paced environment EEO Statement PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

ServiceNow Developer - 100% Remote - Full Time

Remote Full-time

Experienced Customer Support Specialist – Remote Part-Time Opportunity for Passionate Pet Lovers and E-commerce Enthusiasts at arenaflex

Remote Full-time

Senior Manager, Performance Marketing, SEM

Remote Full-time

Field Service Engineer

Remote Full-time

**Experienced Customer Service Representative – Remote Opportunity with arenaflex**

Remote Full-time

Sales Development Representative

Remote Full-time

Experienced Remote Data Entry Associate for Healthcare Industry - Work from Home Opportunity with Professional Growth and Development

Remote Full-time

Pharmacist I job at Mass General Brigham in Boston, MA

Remote Full-time

Office / Operations Coordinator

Remote Full-time

Experienced Part-Time Remote Customer Service Representative for Teens at blithequark

Remote Full-time
← Back to Home