This list contains only the countries for which job offers have been published in the selected language (e.g., in the French version, only job offers written in French are displayed, and in the English version, only those in English).
The primary goal of this position is to manage the complex administrative and compliance-driven processes required for healthcare professionals to practice and for the organization to receive payment. Provider Credentialing (Verification and Compliance) Credentialing is the process of verifying a healthcare provider's qualifications to ensure they meet professional and regulatory standards. It's the quality control step.
Job Responsibility:
End-to-End Enrollment Management
Compliance & Regulatory Adherence
Issue Resolution & Escalations
Investigate and resolve complex enrollment issues—rejections, NPI/taxonomy discrepancies, retro-effective enrollment, and portal conflicts
Serve as a point of escalation for difficult payer inquiries
Coordinate with internal Quality, Credentialing, and Provider Data teams to address blockers
Process Improvement
Identify inefficiencies in the enrollment workflow and recommend enhancements to reduce turnaround time and improve accuracy
Support automation and system-improvement initiatives
Contribute to building standardized templates and best practices
Mentorship & Team Support
Guide and mentor junior Analysts to improve their technical and process knowledge
Provide feedback through reviews, quality checks, and coaching discussions
Participate in team huddles, calibrations, and performance alignment meetings
Documentation & Reporting
Maintain accurate records within CRM, internal workflow tools, payer portals, and tracking sheets
Generate periodic reports on submissions, status updates, pending items, and escalations
Ensure documentation meets audit and compliance expectations
Requirements:
Minimum 2+ years of hands-on experience in Payer Enrollment—Commercial or Medicaid, depending on the requirement