Credentialing & Enrollment Specialist

Matter Health•Nashville, TN

3d•Hybrid

About The Position

Matter Health is seeking an experienced Credentialing & Enrollment Specialist to join our growing team. In this role, you will manage the credentialing, enrollment, and ongoing maintenance of our physicians and advanced practice providers across multiple markets. As a key member of our Credentialing & Enrollment team, you will ensure providers are credentialed, enrolled, and prepared to deliver care. You will collaborate closely with Clinical Operations, Revenue Cycle, Compliance, Human Resources, and external payer organizations. This position is ideal for someone who takes ownership, thrives in a detail-oriented environment, and excels at keeping complex processes organized from start to finish. You will play a critical role in supporting Matter Health’s continued growth by guiding providers through the credentialing and enrollment lifecycle.

Requirements

3+ years of provider credentialing and payer enrollment experience preferred
Demonstrated experience independently managing credentialing and enrollment from application to approval
Working knowledge of Medicare, Medicaid, and commercial payer enrollment processes
Experience using CAQH, PECOS, NPPES, Availity, and payer enrollment portals
Strong understanding of credentialing documentation requirements and provider lifecycle management
Excellent organizational skills with the ability to manage multiple providers and deadlines simultaneously
Meticulous attention to detail and a commitment to accuracy
Exceptional written and verbal communication skills
Ability to work independently while collaborating across multiple departments
Proficiency with Microsoft Office, including Excel

Nice To Haves

Experience within value-based care, primary care, physician groups, or Medicare Advantage organizations
Experience supporting multi-state credentialing and enrollment
Familiarity with delegated credentialing programs
Experience working with advanced practice providers and physicians
Knowledge of credentialing software and provider database management
Process improvement or workflow optimization experience

Responsibilities

Manage all aspects of provider credentialing, recredentialing, and payer enrollment activities from start to finish
Prepare, submit, monitor, and maintain Medicare, Medicaid, and commercial payer enrollment applications
Maintain provider records in CAQH, PECOS, NPPES, and other relevant information systems
Track credentialing and enrollment timelines to ensure providers are approved and ready to practice
Coordinate provider demographic updates, revalidations, and enrollment changes with payer organizations
Monitor application status and proactively resolve credentialing and enrollment issues
Maintain accurate provider records and organize credentialing documentation
Collaborate closely with Clinical Operations, Compliance, Revenue Cycle, HR, and external organizations throughout the credentialing process
Ensure compliance with internal policies, regulatory requirements, and payer guidelines
Identify and implement opportunities to improve credentialing workflows, documentation, and operational efficiency
Support organizational growth by credentialing providers across new and existing markets