Enrollment / Credentialing Specialist Job at Robert Half (Greenwood Village)

Provider Credentialing Specialist

Work with the New Ventures team to complete health plan credentialing accurately...

Location

United States

Salary:

55000.00 - 75000.00 USD / Year

Pomelo Care

Expiration Date

Until further notice

Requirements

2-4 years of experience in a high volume, credentialing specialist role
Deep expertise with commercial health plan credentialing processes, including health plan portals & CAQH
Highly organized with a strong attention to detail
A proactive and resourceful problem-solver who is comfortable navigating ambiguity and independently seeks out answers and solutions
An accountable and collaborative team player with excellent communication skills, both written and verbal
An expert at prioritization & time management, who proactively shares deliverable timelines and roadblocks

Job Responsibility

Complete group & practitioner health plan credentialing on behalf of Pomelo’s telehealth clinic & care team
Track applications from submission to approval, contracting, and agreement, ensuring cross-functional visibility into key milestones & timelines
Proactively mitigate application delays & denials
Rigorously follow up on any delays and/or denials to right-size
Collaborate with Pomelo licensing, credentialing, and enrollment team to ensure proper clinician licensure & up-to-date CAQH profiles, to help expedite health plan credentialing
Collaborates with care team of nurses, nurse practitioners, doctors, therapists & registered dietitians to support navigation & answer questions about clinician credentialing applications

What we offer

Competitive healthcare benefits
Generous equity compensation
Unlimited vacation
Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)

Credentialing Specialist

We are looking for a detail-oriented Credentialing Specialist to join our team o...

Location

United States , Henderson

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proven experience in credentialing, particularly in a healthcare or hospital setting
Proficiency in using credentialing databases, CRM systems, and EHR platforms
Familiarity with the Council for Affordable Quality Healthcare (CAQH) process
Strong knowledge of medical terminology and credentialing standards
Exceptional organizational and auditing skills with high attention to detail
Ability to manage multiple tasks and meet strict deadlines
Certified Provider Credentialing Specialist (CPCS) designation preferred
Proficiency in tools like Adobe Acrobat and Microsoft Office Suite

Job Responsibility

Manage the credentialing process by collecting, reviewing, and verifying applications and supporting documentation
Ensure all physician credentials are accurate, complete, and comply with applicable regulatory standards
Maintain up-to-date records in the credentialing database and other tracking systems
Collaborate with healthcare providers and organizations to resolve discrepancies or incomplete information
Conduct audits to verify compliance with internal policies and external regulatory requirements
Provide support for enrollment with the Council for Affordable Quality Healthcare (CAQH) and other accrediting bodies
Prepare detailed reports on credentialing activities and compliance status
Assist in identifying and implementing improvements to the credentialing process
Stay informed about changes in healthcare credentialing regulations and best practices

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Fulltime

Medical Staff Credentialing Specialist and Coordinator

The Medical Staff Credentialing Specialist and Coordinator assists the Medical D...

Location

United States , Medina

Salary:

50000.00 - 60000.00 USD / Year

Orleans Community Health

Expiration Date

Until further notice

Requirements

Associates Degree or Certified Provider Credentialing Specialist (CPCS)
A minimum of 2-3 Years Credentialing experience is preferred
Excellent verbal and written communication skills, ability to relate well with people of diverse backgrounds, training and experience
Proficiency with medical practice software programs, Familiarity with credentialing requirements of hospitals and insurance carriers
Understanding of Malpractice insurance coverages and policies
Knowledge and understanding of credentialing process
Ability to organize and prioritize work and manage multiply priorities
Ability to research and analyze data
Ability to work independently with minimal supervision
Ability to establish and maintain effective working relationships with providers, management, staff and external contacts

Job Responsibility

Compiles and maintains current and accurate data for all providers
Completes provider credentialing and re-credentialing applications, monitors applications and follow-up as needed
Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
Maintains corporate provider contract files
Maintains knowledge of current health plan and agency requirements for credentialing providers
Sets up and maintains provider information in online credentialing databases and system
Tracks license and certification expirations for all providers to ensure timely renewals
Ensures practice addresses are current with health plans, agencies and other entities
Audits health plan directories for current and accurate provider information
Completes credentialing/re-credentialing application packets for hospital, insurance carriers and government programs

What we offer

vacation and sick time
health, dental and vision
pension and retirement plan
competitive wages, with superior pension and retirement plans with employer contributions
12% shift differential for working evening and night shifts
excellent vacation, holiday and sick leave package
tuition assistance
free parking

Fulltime

Credentialing Specialist

We are in search of a skilled Credentialing Specialist to join our team in South...

Location

United States , Southborough

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 5 years experience as a Credentialing Specialist or a similar role in the healthcare industry
Proficiency in computerized billing systems and electronic health record (EHR) systems
Experience with Epic Software
Solid understanding and experience in accounting functions, specifically in the healthcare setting
Expertise in medical credentialing and medical billing is essential
Proficiency in Microsoft Excel
Demonstrated experience in handling various billing functions
Familiarity with contractual billing, electronic billing, healthcare billing, insurance billing, Medicaid billing, medical insurance billing, Medicare billing, patient billing, physician billing, and third-party billing

Job Responsibility

Collect, review, and validate credentials for healthcare providers, including licenses, certifications, and education
Maintain and update credentialing databases and files for all healthcare providers, ensuring all required documents are current and complete
Adhere to all applicable laws, regulations, and industry standards (e.g., NCQA, CMS, etc.) associated with credentialing
Generate and maintain reports related to credentialing status and compliance and communicate any issues or discrepancies to management
Assist with the enrollment of providers and group facilities into insurance networks and maintain active status with payer organizations
Act as a liaison between healthcare providers, insurance companies, and internal departments to resolve credentialing issues or questions
Participate in internal and external audits of credentialing files, ensuring accurate and timely completion of necessary documentation
Stay informed of changes in regulatory requirements and best practices to ensure the credentialing process remains efficient and compliant
Uphold the dignity and respect of individuals we support and ensure they are treated in accordance with our Human Rights policies
Adhere to all principles related to the Advocates Way

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Credentialing Specialist Lead

The Credentialing Specialist Lead serves as the senior subject matter expert wit...

Location

United States , Long Island City

Salary:

30.00 - 32.00 USD / Hour

The Dermatology Specialists

Expiration Date

Until further notice

Requirements

3+ years of healthcare credentialing experience
dermatology or multispecialty experience preferred
Strong knowledge of CAQH, NPPES, Medicaid, Medicare, and commercial payer portals
Exceptional attention to detail, organization, and follow-through
Excellent communication and interpersonal skills
Proficiency in Excel and credentialing systems
experience with eClinicalWorks a plus

Job Responsibility

Manage the full credentialing lifecycle for physicians, NPs, and PAs — including Medicaid, Medicare, and commercial payer enrollments (Empire BCBS, Fidelis, Aetna, etc.)
Review and verify provider documents such as medical licenses, DEA, board certifications, malpractice coverage, and CVs
Prepare, track, and submit enrollment applications accurately and within payer timelines
Monitor revalidation and re-credentialing schedules to ensure ongoing compliance
Serve as the primary point of contact for escalated payer or provider inquiries
Partner with internal billing and operations teams to ensure credentialing aligns with billing readiness
Maintain credentialing logs, dashboards, and internal trackers for reporting purposes
Assist in training and supporting new credentialing specialists, ensuring quality and consistency across workflows

Credentialing Specialist

The Credentialing Specialist will be responsible for timely submission and follo...

Location

United States , Overland Park

Salary:

Not provided

Aria Care Partners

Expiration Date

Until further notice

Requirements

Minimum two years of health insurance credentialing experience preferred
Prior data management/data integrity experience preferred
Associates degree preferred
Proficient with Microsoft Office, including Excel, Word, and Outlook
Excellent organization and communication skills
Quick thinking, positive, and professional, with demonstrated problem solving, attention to detail, and critical thinking skills
Ability to work independently, set priorities, and meet deadlines
Adapt to changes in work environment, manage competing demands and deal with frequent change, delays, or unexpected events
Able to work in a team environment

Job Responsibility

Prepare and submit credentialing applications and supporting documentation for the purpose of enrolling groups and providers with Commercial, Medicare, and Medicaid networks
Follow up on the status of applications for providers with payers, tracking progression of pending and completed work
Maintains accurate and up-to-date database of information including provider credentials and payer statuses
Works closely with internal teams to communicate approvals and work through denials as necessary
Maintains knowledge of current payer requirements across multiple states and service lines
Maintain strict level of confidentiality and HIPAA compliance
Familiarity with state licensing requirements and provider onboarding tasks
Familiarity with various payer portals and CAQH
Contact providers and payers, by phone or email, for updates and/or to request missing information
Ensure group and provider information is current/accurate with health insurance payers

What we offer

PTO and Paid Holidays for FT Employees
401k Retirement Plan with Company Match
Insurance programs including medical, dental, vision, company match for your HSA, FSA, company-paid EAP, and life and disability insurance, and more

Fulltime

Client Partner – Credentialing Specialist

Join our team in Manila as a Client Partner - Credentialing Specialist. We are s...

Location

Philippines , Taguig City

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Strong knowledge of Payer Processes and Credentialing
Willingness to work continuously in night shifts
Must be fluent in English language
Willing to work in the night shift at our office in McKinley Hill, Taguig
Must have at least 1 year of experience in Credentialing processes for US healthcare customers

Job Responsibility

Manage the end-to-end provider enrollment process, ensuring healthcare providers are properly credentialed and enrolled with insurance networks
Conduct thorough review of provider documentation, ensuring compliance with credentialing requirements and proactively resolving any discrepancies
Serve as a liaison between healthcare providers and insurance companies, addressing enrollment-related inquiries and facilitating timely resolution
Maintain accurate and up-to-date provider information in databases, and collaborate with internal teams to streamline the enrollment and billing processes

Credentialing Enrollment Specialist

Location

United States , Charlotte

Salary:

24.10 - 36.15 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

High school diploma or GED required
Bachelor's degree preferred
Three years' experience in a role that performs or supports provider credentialing, privileging, and/or enrollment in either a hospital, managed care plan or CMS environment
Knowledge of and experience with personal computers, Windows and Microsoft applications, copier and fax machines and multi-line telephone
Experience in typing, word processing, and business correspondence
Certification through National Association of Medical Staff Services (NAMSS) as Certified Provider Credential Specialist (CPCS) or Professional Medical Services Management (CPMSM) preferred

Job Responsibility

Performs primary source verifications of documentation required for managed care credentialing and re-credentialing of MGD providers
Provides issue resolution and support regarding billing issues as they relate to provider enrollment and credentialing for MGD providers and the Central Billing Office
Enters provider data in the ECHO database according to established departmental processes and provides feedback to other System entities as to the status of the applicants
Performs follow-up on needed information (expired licenses, board certifications insurance and DEA registrations) on an ongoing basis and ensures receipt of same in a timely manner
Prepares physician files for file audits by managed care organizations, Corporate Compliance and accreditation entities
Conducts practice site visits for practices within MGD
Facilitates communication tools and or activities to maintain timely and accurate flow of information to Managed Care Organizations (MCOs) and the System
Reviews hard copy and electronic provider directories and other information produced by managed care organizations reflecting MGD and the System's demographics and participation
Provides Team member support to the CPN Credentialing and Quality Review Committee

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Enrollment / Credentialing Specialist

Robert Half

Location:
United States , Greenwood Village

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 08, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Enrollment / Credentialing Specialist

Provider Credentialing Specialist

Credentialing Specialist

Medical Staff Credentialing Specialist and Coordinator

Credentialing Specialist

Credentialing Specialist Lead

Credentialing Specialist

Client Partner – Credentialing Specialist

Credentialing Enrollment Specialist

Enrollment / Credentialing Specialist

Robert Half

Location:United States , Greenwood Village

Category:Health and Beauty

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:February 08, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Enrollment / Credentialing Specialist

Provider Credentialing Specialist

Credentialing Specialist

Medical Staff Credentialing Specialist and Coordinator

Credentialing Specialist

Credentialing Specialist Lead

Credentialing Specialist

Client Partner – Credentialing Specialist

Credentialing Enrollment Specialist

Location:
United States , Greenwood Village

Category:
Health and Beauty

Contract Type:
Not provided

Job Posted:
February 08, 2026