Credentialing & Payor Enrollment Specialist

The Credentialing & Payor Enrollment Specialist manages the complete lifecycle of provider placement, including medical staff credentialing, allied health onboarding, and managed care plan enrollment. This role processes applications for appointments and reappointments while executing enrollment and re-credentialing processes for medical group and hospital-based providers. The position involves maintaining provider databases, updating CAQH registries, monitoring compliance tracking, and corresponding with health plans and government entities. It requires utilizing advanced office technology and AI-driven tools to optimize data accuracy and streamline administrative workflows while maintaining strict confidentiality and compliance with privacy regulations.