About The Position
Our client is a rapidly growing healthcare technology company enabling Nurse Practitioners to launch and operate independent primary care practices. Their platform handles operational infrastructure, including credentialing and insurance billing, allowing providers to focus on patient care. Role Overview The Contracting & Credentialing Specialist owns end-to-end provider credentialing and payer enrollment across multiple US states. You will manage credentialing pipelines, group contract enrollment, and payer communications, ensuring providers launch on time. This is a highly autonomous, execution-heavy role where you proactively identify blockers, escalate when necessary, and build SOPs from scratch. Ideal candidates thrive in fast-paced, high-growth environments, think like owners, and can operate independently without detailed instructions. Your Impact: Ensure timely provider launches by managing credentialing and enrollment pipelines across multiple states Reduce time-to-launch by proactively identifying and resolving credentialing blockers Maintain accurate master tracking systems and communicate updates proactively Support expansion into new states and payer relationships Contribute to building scalable processes and documentation for the credentialing function
Requirements
- 3+ years experience in provider credentialing, payer enrollment, or payer contracting
- Experience across at least 3 US states
- Experience credentialing Nurse Practitioners
- Hands-on experience with group contract enrollment
- Proficiency with CAQH, PECOS, Availity, and payer portals
- Strong spoken English — comfortable making payer phone calls
- Highly organized with ability to manage multiple workflows simultaneously
- Self-directed and proactive; able to escalate blockers and suggest solutions
- CAQH, PECOS, Availity, payer-specific portals, Google Sheets, Slack, Notion
Nice To Haves
- Experience in Arizona, Washington, Oregon, Colorado, Utah, Minnesota, or Nevada
- Familiarity with delegated credentialing processes
- Background in primary care or Nurse Practitioner-specific credentialing
- Experience in startup, MSO, or provider network environments
- Experience building SOPs or process documentation
- Credentialing management software or platforms (open to recommending tools)
Responsibilities
- Manage end-to-end credentialing and recredentialing of Nurse Practitioners with commercial, Medicare, and Medicaid payers
- Prepare and submit applications via CAQH, PECOS, Availity, and payer-specific portals
- Track application status and proactively follow up with payers to accelerate approvals
- Identify and escalate credentialing blockers to leadership before they impact launch dates
- Maintain CAQH revalidation and ensure provider profile accuracy
- Prepare and submit group-level enrollment and contracting materials for new markets
- Enroll providers under existing group contracts, ensuring correct payer attachment
- Coordinate provider additions, location changes, and tax ID updates across payers
- Maintain master credentialing tracker in Google Sheets with accurate, current data
- Communicate credentialing timelines and blockers proactively via Slack
- Prioritize workflows based on provider launch dates
- Support onboarding of providers under group payer contracts
- Assist with document collection, submission, and record-keeping
- Maintain organized records of payer contracts and related documentation
- Build SOPs and call scripts for payer communication from scratch
- Serve as internal point of contact for credentialing and enrollment questions
- Coordinate with in-house billing team to align on claim flags and provider status
Benefits
- Competitive Salary: Based on experience and skills
- Remote Work: Fully remote—work from anywhere
- Performance Bonus: Based on data accuracy, reporting timeliness, and overall sales efficiency
- Team Incentives: Recognition for maintaining 100% CRM hygiene and on-time reporting
- Generous PTO: In accordance with company policy
- Health Coverage for PH-based talents: HMO coverage after 3 months for full-time employees
- Direct Mentorship: Guidance from international industry experts
- Learning & Development: Ongoing access to resources for professional growth
- Global Networking: Connect with professionals worldwide
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
