Credentialing and Provider Enrollment Specialist

• Prepare, submit, and track Medicare enrollment applications through PECOS, including individual, group, and reassignment of benefits applications
• Respond to Medicare Administrative Contractor development requests and correct application issues
• Complete Medicaid and commercial payer credentialing and contracting applications for new and existing practice locations
• Create, update, and re-attest CAQH ProView profiles using provider-authorized access
• Maintain NPI, license, DEA, board certification, malpractice, and hospital privilege records with expiration dates
• Follow up with payers by phone, email, and portal until applications are approved and effective dates are confirmed
• Track application status, reference numbers, and effective dates in the practice's credentialing tracker
• Notify the practice of approvals, denials, missing documents, and upcoming revalidation or re-credentialing deadlines
• Process demographic updates such as new locations, address changes, and added services with each payer
• Protect patient and provider information and follow HIPAA requirements

• At least 2 years of experience with U.S. healthcare credentialing and provider enrollment
• Hands-on experience submitting and managing Medicare applications in PECOS, including CMS-855 enrollment and reassignment
• Familiarity with commercial insurance and government health plans
• Experience with CAQH ProView, NPPES, and payer enrollment portals
• Strong written and spoken English
• Excellent attention to detail and follow-up skills
• Ability to work independently and manage multiple applications and deadlines
• Reliable internet connection and a suitable remote workspace
• Experience credentialing surgeons or specialty practices such as orthopedics, spine, or pain management (preferred)
• Experience enrolling a newly formed group practice, including multiple locations (preferred)
• Familiarity with Georgia Medicaid and Georgia commercial insurance plans (preferred)
• Experience with hospital and ambulatory surgery center privileging (preferred)

• Remote work arrangement
• Part-time schedule
• Must be available during Eastern Time business hours