Provider Enrollment & Credentialing Specialist

Pinnacle Wound Management • Gainesville, GA

1d

About The Position

The Provider Enrollment & Credentialing Specialist will be responsible for the full-cycle credentialing and enrollment of our healthcare providers, including physicians and mid-level practitioners. This role is vital to ensuring that our clinical staff are enrolled with payers, credentialed with facilities, and compliant with all regulatory and operational standards.

Requirements

• 2+ years of experience in healthcare credentialing and/ or provider enrollment.
• Familiarity with CAQH, PECOS, NPPES, and commercial insurance enrollment processes.
• Strong organizational skills and attention to detail.
• Ability to work independently and manage multiple tasks and deadlines.
• Excellent communication skills, both written and verbal.
• Experience in wound care or with mobile healthcare providers is a plus.

Nice To Haves

• Knowledge of credentialing software and platforms.
• Experience working with a geographically distributed provider team.
• Understanding of state licensing requirements and compliance standards.

Responsibilities

• Manage the credentialing and re-credentialing processes for physicians, nurse practitioners, and physician assistants.
• Enroll new providers with Medicare, Medicaid, and commercial insurance plans.
• Maintain accurate and up-to-date provider information in internal databases and with payer systems.
• Track expirables (e.g., licenses, certifications, malpractice insurance) and ensure timely renewals.
• Communicate with providers and internal departments to gather necessary documentation and resolve enrollment or credentialing issues.
• Monitor and respond to payer requests and follow up to ensure timely processing.
• Stay current on enrollment and credentialing regulations and payer requirements.
• Support facility privileging processes when applicable.

Benefits

• Opportunity to be part of a mission-driven team making a direct impact on patient care.
• Supportive and collaborative work environment.
• Competitive salary and benefits package.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed