Credentialing & Enrollment Specialist

Want to learn more about this role and Jobot? Click our Jobot logo and followour LinkedIn page!Job details:Join a mission-driven nonprofit healthcare organization and help ensure providers are credentialed, enrolled, and ready to serve the Albuquerque community.This Jobot Job is hosted by: Giulia SaierAre you a fit? Easy Apply now by clicking the "Easy Apply" buttonand sending us your resume.Salary: $50,000 - $60,000 per yearA bit about us:Mission-driven nonprofit healthcare organizationOpportunity to directly support access to healthcare in the Albuquerque communityCollaborative environment working with providers, clinical leadership, billing, HR, and administrative teamsStable organization with an important community missionOpportunity to take ownership of provider credentialing and enrollment processesComprehensive benefits and opportunities for professional growth.Why join us?Mission-driven nonprofit healthcare organizationOpportunity to directly support access to healthcare in the Albuquerque communityCollaborative environment working with providers, clinical leadership, billing, HR, and administrative teamsStable organization with an important community missionOpportunity to take ownership of provider credentialing and enrollment processesComprehensive benefits and opportunities for professional growthJob DetailsThe Credentialing & Enrollment Specialist will coordinate provider credentialing, recredentialing, and payer enrollment activities to ensure healthcare providers remain properly credentialed and eligible to provide and bill for services.This position requires exceptional attention to detail, organization, follow-through, and the ability to manage multiple provider files and deadlines simultaneously.Responsibilities include:Coordinate initial credentialing and recredentialing for physicians, advanced practice providers, behavioral health professionals, and other -applicable healthcare providersComplete and submit provider enrollment applications with Medicare, New Mexico Medicaid, commercial insurance plans, and other third-party payersMaintain and update provider information within CAQH and other payer or credentialing systemsTrack credentialing and enrollment applications from initial submission through approvalFollow up with insurance carriers and other organizations regarding outstanding applications, documentation, and enrollment statusMaintain accurate provider credentialing files and databasesVerify and monitor professional licenses, board certifications, DEA registrations, malpractice coverage, and other required credentialsTrack expiration and renewal dates and proactively obtain updated documentationAssist providers with completing applications, obtaining signatures, and submitting required documentationCoordinate provider additions, terminations, demographic changes, and other updates with insurance carriersSupport provider onboarding by ensuring credentialing and payer enrollment requirements are completed accurately and efficientlyWork closely with Billing, Human Resources, Compliance, clinic leadership, and providers to resolve credentialing or enrollment issuesMaintain confidentiality of provider and organizational informationAssist with audits and ensure credentialing documentation remains complete, accurate, and compliantIdentify delays or discrepancies that could impact provider enrollment or reimbursement and work proactively toward resolutionWhat We're Looking For:Previous experience with healthcare credentialing, provider enrollment, medical staff services, or a closely related healthcare administrative functionExperience with Medicare, Medicaid, and/or commercial payer enrollment strongly preferredKnowledge of CAQH and electronic provider enrollment systems preferredFamiliarity with New Mexico Medicaid enrollment is highly desirableUnderstanding of provider licensing, certifications, DEA registrations, malpractice coverage, and credentialing documentationStrong organizational skills and exceptional attention to detailAbility to track multiple providers, applications, deadlines, and renewals simultaneouslyStrong written and verbal communication skillsComfortable communicating directly with healthcare providers, insurance carriers, and internal departmentsStrong computer skills, including Microsoft Office and healthcare administrative systemsAbility to independently research issues and follow applications through completionExperience within a nonprofit, community health center, FQHC, or similar healthcare environment is a plusInterested in hearing more? Easy Apply now by clicking the "Easy Apply" button.Jobot is an Equal Opportunity Employer. We provide an inclusive work environment that celebrates diversity and all qualified candidates receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, age (40 and over), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. Jobot also prohibits harassment of applicants or employees based on any of these protected categories. It is Jobot’s policy to comply with all applicable federal, state and local laws respecting consideration of unemployment status in making hiring decisions.Sometimes Jobot is required to perform background checks with your authorization. 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