[Hiring] Payer Enrollment & Credentialing Specialist @AIS Healthcare

Role Description

The Payer Enrollment & Credentialing Specialist is responsible for supporting the end-to-end payer credentialing lifecycle for a national network of home infusion pharmacies, specialty pharmacies, infusion centers, and affiliated clinical providers. This position coordinates credentialing and recredentialing activities, validates provider and organizational data, maintains credentialing records, and ensures all required documentation meets payer, regulatory, and accreditation standards. The role is critical to maintaining active network participation and preventing service disruptions related to credentialing gaps.

What You'll Do

• Coordinate payer credentialing and recredentialing activities for specialty pharmacies, infusion centers, and affiliated providers
• Prepare, complete, and submit payer enrollment and credentialing applications accurately and within established deadlines
• Manage Medicare and Medicaid enrollment and revalidation submissions
• Maintain organized records of licenses, accreditations, insurance documents, provider credentials, and enrollment documentation
• Serve as the primary point of contact for payer credentialing departments regarding application statuses, delays, and resolution of issues
• Monitor credentialing milestones and maintain accurate records within Salesforce and credentialing databases
• Track application progress and proactively communicate updates to internal stakeholders
• Maintain detailed documentation to satisfy commercial, government, and third-party payer requirements
• Ensure provider information is accurate and consistent across credentialing platforms and payer applications
• Support compliance with regulatory, accreditation, and contractual requirements
• Protect patient privacy and maintain confidentiality in accordance with HIPAA guidelines
• Assist with special projects and additional duties as assigned

Qualifications

• Minimum of 3 years of payer credentialing experience
• Experience completing payer credentialing applications through multiple submission methods
• Experience with Medicare and Medicaid payer enrollment processes
• Experience working within home infusion, specialty pharmacy, provider services, or healthcare organizations
• Working knowledge of CAQH, PECOS, NPPES, NCPDP
• Ability to interpret and utilize provider taxonomy codes, NPIs, and other provider identifiers
• Experience managing multiple applications simultaneously while meeting deadlines
• Strong organizational skills and attention to detail
• Excellent verbal and written communication skills
• Ability to work independently in a remote environment
• Proficiency with Microsoft Outlook, Word, Excel, and SharePoint

Preferred Qualifications

• Medicare and Medicaid enrollment and revalidation experience
• Home Infusion experience
• Specialty Pharmacy experience
• Experience navigating contract management software
• Experience supporting provider and organizational credentialing initiatives across multiple states

How to Apply

To be considered for this position, you must complete the Culture Index Assessment.

Culture Index Assessment: http://portal.cultureindex.com/public/survey/general/0BFB8F0000

Important: Applications will not be reviewed until the assessment has been completed. If the assessment link does not open when clicked, please copy and paste the URL directly into your browser. If you continue to experience issues, try using a different browser.