Payor Credentialing Specialist

Echo AI (acquired by Calabrio)

Payor Credentialing Specialist performing enrollment and credentialing duties for healthcare providers at ERC Pathlight. Collaborating with physicians and managing compliance processes in healthcare.

Posted 7/16/2026full-timeRemote • Colorado • 🇺🇸 United StatesMid-LevelSenior💰 $21 - $29 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in coordinating the credentialing and enrollment processes for healthcare providers, ensuring compliance with regulations and maintaining accurate provider records. Proficient in utilizing credentialing databases and software to support efficient operations and audits.

Highest-signal resume keywords

Credentialing Process CoordinationProvider EnrollmentMD Staff Software ExperienceCertified Provider Credentialing Specialist (CPCS)Healthcare Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Credentialing ApplicationsProvider VerificationApplication Status MonitoringAudit-Ready File MaintenanceCredentialing Report Generation

Soft Skills

Strong Organization SkillsDetail OrientedProfessional CommunicationMulti-TaskingPrioritization

Tools & Technologies

MD StaffCAQHPECOSNPPES

Certifications & Qualifications

Certified Provider Credentialing Specialist (CPCS)Certified Provider Enrollment Specialist (CPES)

Industry Keywords

Healthcare CredentialingProvider Enrollment ProcessMedicareMedicaidManaged Care OrganizationsHIPAA Compliance

About the role

Key responsibilities & impact

Coordinate the credentialing, recredentialing, and provider enrollment process for physicians, advanced practice providers, and allied health professionals.
Complete, review, and submit credentialing and enrollment applications to Medicare, Medicaid, commercial insurance carriers, and managed care organizations.
Monitor application status, follow up with payors, and resolve deficiencies to ensure timely provider enrollment.
Verify provider credentials, including licensure, education, training, certifications, work history, malpractice coverage, and other required documentation.
Maintain provider records in credentialing databases: MD Staff, CAQH, PECOS, NPPES, and other applicable systems, enabling tracking of credential expiration dates and maintenance of audit-ready files.
Coordinate with providers and internal departments to obtain required documentation and respond to requests from payors for additional information.
Research and resolve credentialing and enrollment issues affecting provider participation and reimbursement.
Generate credentialing reports, maintain enrollment status reports, and support internal and external audits.
Ensure compliance with federal and state regulations, accreditation standards, HIPAA, and organizational policies; communicate credentialing status updates to leadership and providers.
Participate in process improvement initiatives.
Willingness to work occasional nights and weekends with up to 25% of travel required.

Requirements

What you’ll need

High School or GED - Required
Bachelors Degree in Business, healthcare, or any related field of study. Equivalent years of experience (in addition to requirement) may be substituted for degree. (Preferred)
Certified Provider Credentialing Specialist (CPCS) or Certified Provider Enrollment Specialist (CPES) by the National Association of Medical Staff Services (NAMSS) (Preferred)
Strong organization skills. Detail oriented. Ability to multi-task and prioritize.
Able to communicate in a professional manner both verbally and in writing.
Minimum of 3 years of experience in healthcare facility credentialing and physician credentialing.
Experience utilizing MD Staff Software

Benefits

Comp & perks

Competitive compensation
Comprehensive medical, dental, and vision coverage
Generous Paid Time Off
Parental Leave benefits
Retirement benefits
Tuition reimbursement