[Hiring] Medical Credential Expert @InboxZeroVA

Role Description

We are seeking a detail-oriented Provider Credentialing & Enrollment Specialist to manage end-to-end credentialing, payer enrollments, and compliance processes for healthcare providers. This role ensures accurate documentation, timely submissions, and adherence to state and federal regulations while coordinating closely with clinics, providers, and insurance payers.

• Oversee initial credentialing and re-credentialing of providers, including CAQH profile maintenance, license tracking, and audit-ready documentation
• Manage payer enrollment applications and provider packets for Medicare, Medicaid, and commercial insurance plans
• Track credentialing and enrollment status, follow up with payers, and resolve delays or issues
• Maintain credentialing databases, files, and records with high accuracy and organization
• Coordinate with clinics and providers to obtain required documents and verify information
• Monitor license expirations, renewals, and compliance deadlines
• Ensure compliance with state and federal regulations and internal policies

Qualifications

• 1–3+ years of experience in provider credentialing, enrollment, or healthcare administration
• Familiarity with CAQH, Medicare, Medicaid, and commercial payer processes
• Strong attention to detail and organizational skills
• Excellent written and verbal communication skills
• Ability to manage multiple deadlines and follow up proactively
• Proficiency in spreadsheets, credentialing software, and document management systems

Requirements

• Preferred: CPCS, CPMSM, or related certification
• Experience working with multi-state providers or telehealth groups

Benefits

• Competitive compensation
• Opportunities for growth and certification support
• Collaborative and fast-paced healthcare environment

Work Setup

• Remote
• Full-time | Monday–Friday