[Hiring] Credentialing & Enrolment Specialist @ReWorks Solutions

Role Description

We are seeking a detail-oriented Provider Credentialing & Enrolment Specialist to manage the credentialing and enrolment process for healthcare providers. This role is responsible for:

• Verifying provider qualifications
• Coordinating insurance network enrolments
• Maintaining credentialing records
• Ensuring providers meet all regulatory and payer requirements before delivering patient care

The ideal candidate will have strong administrative, organizational, and communication skills, with experience in healthcare compliance, provider onboarding, or medical administration.

Qualifications

• Previous experience in healthcare administration, provider credentialing, provider enrollment, medical staff services, or healthcare compliance
• Strong understanding of healthcare credentialing and provider onboarding processes
• Experience working with medical licensing boards, regulatory authorities, or insurance providers
• Excellent attention to detail and organizational skills
• Strong written and verbal communication skills
• Ability to manage multiple priorities while meeting deadlines
• Proficiency in Microsoft Office (Word, Excel, Outlook)
• Comfortable working U.S. hours

Requirements

• Perform primary source verification of healthcare provider licenses, medical degrees, certifications, training, and professional credentials
• Verify provider eligibility with licensing boards, regulatory authorities, and credentialing organizations
• Ensure all credentialing documentation is complete, accurate, and compliant with regulatory and organizational requirements
• Monitor license, certification, and registration expiration dates and coordinate timely renewals
• Prepare, complete, and submit provider enrolment applications to private medical insurance networks and government healthcare programs
• Manage provider identification numbers and government health registry listings
• Track enrolment applications from submission through approval and resolve any outstanding requirements
• Work proactively to prevent enrolment delays that may impact provider billing or reimbursement
• Maintain accurate and confidential electronic and physical provider credentialing files
• Ensure all provider records remain current and compliant with internal policies and external regulatory standards
• Conduct regular audits of provider files to ensure completeness and accuracy
• Maintain documentation in accordance with healthcare privacy and compliance regulations
• Guide healthcare providers through the credentialing and onboarding process, ensuring all required documentation is submitted
• Serve as the primary point of contact between healthcare providers, medical licensing boards, insurance companies, and credentialing organizations
• Respond to credentialing and enrolment queries in a professional and timely manner
• Provide regular progress updates to hospital leadership, human resources, and other internal stakeholders

Benefits

• Remote work from home

Company Description

Fraud Disclaimer: ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.