Position Overview:

We are looking for a Payor Contracting/Credentialing Specialist who is experienced with obtaining commercial payor contracts, managing medical practice and provider enrollments, and ensuring compliance with payor requirements. This role requires someone highly organized, detail-oriented, and skilled in handling contracting and credentialing processes end-to-end.

🔹 Key Responsibilities

• Obtain, negotiate, and maintain commercial payor contracts for the medical practice
• Manage practice/provider credentialing and re-credentialing processes
• Complete and submit enrollments with insurance payors (Medicare, Medicaid, commercial)
• Maintain and update provider records and documentation
• Track application statuses and timely follow up with payors
• Ensure compliance with all regulatory requirements

🔹 Qualifications

• 2 years of proven experience in contracting and credentialing for US healthcare organizations and providers
• Detailed knowledge of CAQH and payor enrollment processes
• Experience with PECOS Medicare enrollment and revalidation
• Strong organizational and tracking skills
• Excellent English communication skills

🔹 Preferred

• Experience working with multiple providers or group practices
• Knowledge of licensing and compliance requirements

Hardware and Software Requirements:

Hardware:

• AMD Ryzen 3 3200G APU or Intel Core i5 (at least 7th gen) Intel CPU
• 16GB DDR4 RAM and 120 – 480gb SSD
• Jabra Biz 1100 / Logitech H390 or similar Noise-canceling Headset
• 1 – 2 Monitors (at least 21in)
• 1080p HD Webcam
• Internet Speed: 50mbps (Fiber/DSL) LTE not accepted

Software:

• Genuine Windows 10 Licensed Computer
• Microsoft Office Suite