Sr. Credentialing & Payor Relations Specialist
About The Position
The Sr. Credentialing and Payor Relations Specialist is an on-site role responsible for provider enrollment, credentialing, payor contracting, and strategic payor initiatives across multiple clinic locations. The role oversees the provider credentialing lifecycle, including new enrollments, recredentialing, and annual renewals, and supports provider transitions related to practice acquisitions, network consolidations, and corporate asset deals. The specialist serves as a liaison for multi-state payor relations, coordinating enrollment activities, maintaining provider participation, optimizing commercial payor contracts, and supporting contract renegotiations. The role works with Human Resources, Operations, Compliance, and Practice Leadership to coordinate provider onboarding and advance organizational growth through credentialing and payor strategies. This is a full-time, in-office position in Brentwood, Tennessee. No travel is required; work days and hours are typically Monday through Friday.
Requirements
- Minimum 3–5 years of experience in provider credentialing, payor enrollment, healthcare revenue cycle operations, or physician practice administration.
- Experience working with commercial insurance payors, Medicare, and Medicaid programs.
- Proficiency with PECOS and applicable provider enrollment systems.
- Strong project management and organizational skills, with the ability to manage multiple priorities simultaneously.
- High school diploma or equivalent.
Nice To Haves
- Degree in Healthcare Administration or a related field.
- Certified Provider Credentialing Specialist (CPCS) certification.
- Certified Professional Medical Services Management (CPMSM) certification.
- Experience supporting multi-state healthcare organizations or acquisition integrations.
Responsibilities
- Coordinate full onboarding and credentialing cycles for new and existing healthcare providers.
- Collect, verify, and maintain provider documentation, including licenses, certifications, and malpractice insurance.
- Track credentialing timelines, compliance requirements, expiration dates, and yearly renewals using digital dashboards.
- Communicate directly with providers to resolve missing documentation and clarify enrollment statuses.
- Direct payor enrollment transitions during corporate acquisitions, mergers, and structural asset deals.
- Research, prepare, and renegotiate payor contracts and fee schedules to maximize reimbursements.
- Coordinate ongoing relations with commercial, Medicare, and Medicaid payors across multiple states.
- Partner with HR, Operations, and Compliance teams to ensure a seamless provider onboarding pipeline.
- Identify opportunities to optimize workflows, tracking tools, and departmental efficiency.
- Provide general administrative and project coordination support to management as needed.
Benefits
- Group medical, dental, vision, and other supplemental policies.
- Flexible Medical Spending Accounts (FSA).
- Health Savings Account (HSA).
- 401(k) with 50% match.
- Paid time off.
- Seven paid holidays.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
