Enrollment / Credentialing Specialist

Our client, a large and growing healthcare organization in the Denver Tech Center, is seeking a detail-oriented Enrollment & Credentialing Specialist to join their team. This position plays a critical role in ensuring the organization's operations remain properly enrolled with Medicare, Medicaid, and commercial insurance payors nationwide.

This is an excellent opportunity for someone who enjoys research, problem-solving, and navigating complex processes. Success in this role requires exceptional attention to detail, strong organizational skills, professional communication, and the ability to work independently while managing multiple priorities.

Key Responsibilities

• Manage provider and organizational enrollment activities with Medicare, Medicaid, and commercial insurance payors across multiple states.
• Research and prepare enrollment applications, updates, revalidations, and maintenance requests.
• Coordinate with internal departments to gather required documentation, tax information, ownership details, and supporting records for submissions.
• Monitor enrollment status and follow up with payors to ensure timely processing and completion.
• Maintain accurate credentialing and enrollment records within internal systems.
• Track and manage all work through a ticketing system, documenting activities, updates, and outcomes.
• Support credentialing and enrollment initiatives for a national operation consisting of approximately 200 locations.
• Assist with special projects, including ownership changes, acquisitions, and other regulatory updates.
• Ensure compliance with CMS, Medicare, Medicaid, and commercial payor requirements and deadlines.
• Communicate professionally with regional leaders and stakeholders nationwide to obtain information and provide status updates.
• Review documentation for accuracy and completeness to minimize delays or denials.

Special Project Responsibilities

• Support time-sensitive ownership change submissions to CMS and other regulatory agencies.
• Coordinate collection of required legal, tax, and operational documentation.
• Manage strict submission deadlines to ensure uninterrupted Medicare and Medicaid participation.
• Collaborate closely with multiple departments to navigate complex organizational structures and regulatory requirements.

Qualifications:

• Exceptional attention to detail and organizational skills.
• Strong professionalism and communication skills.
• Ability to quickly learn complex processes and retain information.
• Self-motivated with the ability to work independently after training.
• Reliable attendance and strong commitment to meeting deadlines.
• Strong research and problem-solving abilities.
• Proficiency with Microsoft Outlook, Teams, and basic Microsoft Excel.
• Minimum typing speed of 40 WPM.
• Ability to draft professional emails and communicate effectively with stakeholders across the country.

Preferred

• Experience with Medicare, Medicaid, or commercial payor enrollment processes.
• Healthcare credentialing experience, including provider or organizational credentialing.
• Experience working within physician groups, healthcare organizations, insurance companies, or related healthcare environments.
• Familiarity with ambulance services, ambulance billing, healthcare revenue cycle, or medical billing processes.
• Experience managing regulatory documentation and compliance-related submissions.

Compensation

About Us

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