Credentialing Specialist (Payer Enrollment)

Lumexa Imaging•Charlotte, NC

About The Position

The Credentialing Specialist (Payer Enrollment) is responsible for enrolling healthcare facilities with commercial insurance payers, Medicare, and Medicaid to ensure timely reimbursement for services rendered. Manage the application process, track credentialing status, and resolve enrollment issues. This role requires attention to detail, knowledge of healthcare regulations, and strong communication skills to coordinate with multiple internal departments and insurance companies effectively.

Requirements

A minimum of two years of payer enrollment experience
Knowledge and understanding of the credentialing and enrollment process
Strong familiarity with medical provider numbers such as NPI (National Provider Identifier) and TIN (Tax Identification Number).
Ability to organize and prioritize work and manage multiple priorities
Excellent verbal and written communication skills
Excellent attention to detail
Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
Proficient use of Microsoft Office applications (Word, Excel, SharePoint) and credentialing software

Nice To Haves

MD Staff software experience a plus

Responsibilities

Prepare, submit, and track enrollment applications, re-credentialing packets, and demographic updates with commercial and government payers.
Proactively communicate with insurance representatives to track application status, resolve processing errors, and shorten approval timelines.
Manage, update, and audit provider information in centralized databases like CAQH, PECOS, and NPPES.
Coordinate with the broader billing, compliance, and operations teams to align enrollment data across the organization's practice management systems.
Investigate and resolve claim rejections or delays that stem from provider enrollment or taxonomy errors.