[Hiring] Provider Enrollment & Credentialing Specialist @PedIM Healthcare

Role Description

PedIM Healthcare is seeking an experienced Provider Enrollment & Credentialing Specialist to support our growing organization. This role is responsible for managing complex provider credentialing and payer enrollment processes across multiple entities, locations, and states. This is a high-impact role requiring prior experience and the ability to work independently in a fast-paced, multi-entity healthcare environment.

Qualifications

• Minimum 2+ years of credentialing and enrollment experience in a healthcare setting
• Strong knowledge of payer enrollment processes and CAQH
• Experience working with Medicare, Medicaid, and commercial insurance plans
• Ability to manage high-volume, detail-oriented work independently
• Strong organizational and follow-up skills
• Excellent communication skills

Requirements

• Manage end-to-end credentialing and enrollment for providers with Medicare, Medicaid, and commercial payers
• Complete and maintain CAQH profiles, applications, and revalidations
• Coordinate multi-state and multi-location enrollments across multiple tax IDs
• Track application status and proactively follow up with payers to ensure timely approvals
• Maintain accurate and up-to-date provider records and credentialing files
• Ensure compliance with CMS guidelines and regulatory requirements
• Collaborate with internal teams including HR, operations, and billing
• Identify and resolve enrollment issues that may impact provider billing or revenue

Benefits

• Health coverage + Sick-N-Well membership
• Health Savings Account (HSA)
• Life insurance
• Paid time off
• 401(k) plan + 4% company match
• Relax Scofa membership
• Employee Assistance Program (EAP)
• Employee Recognition Program
• And more!