Physician Enrollment & Credentialing Specialist

Critical Care Pulmonary and Sleep Associates • Lakewood, CO

1d • Remote

About The Position

Critical Care, Pulmonary and Sleep Associates (CCPSA) is a multispecialty private physician practice providing critical care, pulmonary and sleep medical services to the Denver metro area. The Physician Enrollment & Credentialing Specialist is responsible for provider credentialing, enrollment, appointments and privileging across commercial insurance payers, government programs, hospitals and other healthcare organizations. The role supports timely reimbursement and uninterrupted patient care by maintaining accurate provider records and meeting credentialing and regulatory requirements. It works in partnership with providers, internal teams, hospitals and insurance carriers, and supports continuous improvement and CCPSA’s collaborative culture.

The position is available part-time, with the potential for full-time employment depending on candidate interest and operational needs. Additional responsibilities may support other practice operations and administrative functions. The position is primarily remote, but candidates must reside in the Denver metropolitan area to accommodate occasional in-office meetings, training and other practice needs.

Requirements

• High school diploma or GED required.
• Minimum of two years of experience in provider credentialing and/or payer enrollment preferred.
• Working knowledge of medical terminology, provider taxonomy, commercial and government payer guidelines, and credentialing requirements.
• Excellent analytical, organizational, problem-solving and critical-thinking skills.
• Commitment to exceptional customer service through professional communication, responsiveness and timely follow-up.
• Ability to work independently, manage multiple competing priorities and consistently meet deadlines.
• Strong written and verbal communication skills.
• Proficiency in Microsoft Outlook, Word, Excel, internet research and payer portals.
• Must reside in the Denver metropolitan area to accommodate occasional in-office needs.

Nice To Haves

• Experience with hospital credentialing and privileging is strongly preferred.
• Experience with EPIC Resolute Professional Billing is strongly preferred.
• At least two years of provider credentialing and/or payer enrollment experience is preferred.

Responsibilities

• Ensure providers are credentialed, enrolled, appointed and privileged with commercial and government payers, hospitals and other healthcare organizations to support uninterrupted clinical operations and timely reimbursement.
• Complete provider enrollment, credentialing, recredentialing, revalidation, appointment, privileging and ongoing maintenance activities.
• Coordinate provider onboarding activities related to credentialing and privileging, including hospital applications and other required pre-start activities, as applicable.
• Maintain credentialing records and monitor compliance with licenses, certifications, DEA registrations, malpractice coverage, continuing education and other credentialing requirements.
• Maintain accurate provider information in credentialing systems, payer portals, hospital credentialing systems, CAQH and other required databases.
• Ensure credentialing files meet standards set by NCQA, TJC, CMS, hospitals and payer-specific guidelines.
• Serve as the primary point of contact for questions about provider credentialing, enrollment, appointment and privileging.
• Support additional practice operations and administrative functions based on organizational needs, individual interests and opportunities for professional growth.

Benefits

• Comprehensive medical benefits; the company covers 80–85% of individual or family premiums.
• Dental and vision benefits at no cost to the employee; the company covers 100% of individual or family premiums.
• Life and AD&D benefits.
• Optional additional life and disability insurance at group discounts.
• PTO and holiday pay.
• 401(k) benefits with company contribution after the eligibility period.
• Benefits effective from date of hire, with no waiting period, for eligible full-time employees.

What This Job Offers

• Job Type: Part-time
• Education Level: High school or GED