Payer Credentialing Enrollment Specialist

BLACK RIVER HEALTH INC • Black River Falls, WI

42d • Onsite

About The Position

Black River Health is seeking a highly motivated individual to fill the full-time position of Payer Credentialing Enrollment Specialist.  This position is primarily based at our 8th Street Campus. Don’t miss out on this opportunity! The Payer Credentialing & Enrollment Specialist manages and executes the full payer credentialing and recredentialing process for healthcare facilities and providers. Ensures timely and accurate enrollment with commercial, Medicare, and Medicaid payers to support reimbursement and maintain compliance with credentialing standards and payer contract requirements. Coordinates required documentation, monitors application progress, and acts as the primary liaison between payers, facilities, and internal departments.

Requirements

• High School Diploma or General Education Diploma (GED)
• Minimum of two years of experience in payer credentialing or hospital billing functions
• Proficient with computers, electronic databases, and standard office equipment
• Strong oral and written communication skills

Responsibilities

• Prepares, submits, and tracks initial credentialing and recredentialing applications for facility and provider enrollment with commercial, Medicare, and Medicaid payers.
• Enters and maintains accurate provider data in credentialing databases and systems (e.g. CAQH, PECOS, NPPES).
• Monitors credentialing application progress and follows up with payers until approval and confirmation of network participation is obtained.
• Collaborates with Revenue Cycle team members to resolve enrollment issues and provide timely status updates.
• Maintains confidentiality of provider personal information and adheres to all privacy and regulatory requirements.
• Tracks key performance indicators, including processing timelines, approval rates, and renewal completion metrics, and identifies trends to support process improvements.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees