Provider Credentialing & Enrollment Specialist

We need someone who can own the entire credentialing and enrollment function from initial applications to contract negotiations — with zero handholding. If you know your way around CAQH, PECOS, NPPES, and every major payer portal, and you can juggle multiple providers across multiple states without dropping the ball, this role is for you.

Key Responsibilities

• End-to-end provider enrollment with all commercial and government payers (Medicare, Medicaid, BCBS, Aetna, Cigna, UHC, and more)
• CAQH profile creation, maintenance, and attestation
• PECOS, NPPES, NCTracks, and state Medicaid portal enrollments
• Track and manage credentialing timelines, expiry dates, and re-credentialing across all providers
• Negotiate and manage payer contracts — fee schedules, rates, and terms
• Handle hospital credentialing and privileging
• Maintain accurate, up-to-date records of all credentials, licenses, and enrollments
• Communicate directly with payers, providers, and clients — follow up, escalate, resolve
• Know and apply state-specific rules and requirements for all 50 states
• Generate weekly/monthly credentialing status reports for clients
• Proactively flag issues before they impact billing or collections

Requirements

• Minimum 3 years of hands-on US healthcare credentialing and enrollment experience
• Strong knowledge of all major payers and government programs
• Experience with payer contract negotiation
• Familiar with credentialing software / trackers
• Excellent written and verbal English communication
• Highly organized — able to manage multiple providers simultaneously without errors
• Fast, detail-oriented, and able to work independently
• Comfortable working US shift hours (6:30 PM to 3:30 AM IST)
• Must have a good computer and 100+ Mbps internet connection

Immediate joiners only. Applications from candidates with a notice period will not be considered.

Apply here: drbillerz.com/careers/