Credentialing / Payer Enrollment Specialist – Part-time, Non-Exempt

Applicants must reside in the US.

This position acts as a liaison between Company’s clients and the payers, making sure that all accounts are credentialed and/or set up correctly with payers so that claims process correctly. This department has a key role in onboarding new accounts, and its processes are critical to the success of all accounts.

Download the full job description here.


  • 25-35 hours per week

  • Available during reasonable daytime hours to answer staff questions and contact payers

  • Takes major lead in onboarding new accounts
    • Pays close attention to New Provider Onboarding tracker; accepts meetings with new clients to discuss their setups with payers
    • Ensures that payer enrollment, credentialing, contracting, and demographics work for new accounts is progressing in a timely manner
  • Becomes proficient in credentialing, contracting and demographics processes
    • Ensures that providers are credentialed in as efficient a manner as possible; suggests improvement to protocols as needed
    • Works to facilitate effective communication with providers to obtain information needed for payer enrollment, credentialing, contracting and demographics
    • Applies for new contracts as requested by providers; reviews existing contracts and suggests changes as needed
    • Attempts contract renegotiations for providers with existing contracts that are outdated or have poor fee schedules
    • Ensures that proper customer service is given to all accounts in a timely manner and that department tasks do not fall through the cracks; provides clients with regular updates on work being performed
    • Protects provider specific information in strictest confidence
  • Utilizes Modio Health Software
    • Stays current with updates to Modio
    • Utilizes the software as much as possible to prevent human error and optimize efficiency/communication with payers
  • Effectively communicates with manager all concerns regarding workload and the ability to complete work
    • Asks for help when overwhelmed
    • Makes sure the schedule and assigned workload is reasonable
    • Informs manager when tasks fall behind by more than 5 days from department protocols, so that help can be assigned before the situation worsens
    • Is extremely transparent with manager about all concerns so that issues can be addressed quickly

Knowledge and Skills

  • Two+ years’ experience in contracting and credentialing work with payers
  • Excellent written and verbal communication skills with the ability to effectively communicate and establish collaborative relationships with clients, LBS staff, and insurance companies
  • Experience with Modio Health software is preferred
  • PECOS experience Experience with Microsoft Office products
  • Knowledge of ICD-10, CPT, and HCPCS codes
  • High level of professional communication; written and verbal
  • Typing 60+ words per minute with high accuracy
  • High level of ethics and integrity in all areas
  • Able to prioritize work and meet deadlines
  • Able to establish relationships with multi-levels of staff appropriately
  • Flexibility to work in an extremely fast-paced and dynamic environment
  • Ability to work independently and within a team
  • Strong organizational skills and attention to detail
Job Location
Remote work from: United States Only
Employment Type
Date posted
September 21, 2023
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