Enrollment Specialist

OCHIN, Inc.

Enrollment Specialist managing provider enrollment processes for payer networks at OCHIN. Responsible for credentialing and compliance in healthcare enrollment functions.

Posted 6/25/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $24 - $47 per hourWebsite

About the role

Key responsibilities & impact

Perform all aspects of the payor enrollment processes for providers under the OCHIN Collaborative or contracted third parties
Manage credentialing applications, verify credentials, and maintain provider files internally and externally with payor plans
Timely processing of initial credentialing and recredentialing applications in accordance with regulatory requirements (NCQA, HRSA/FTCA, Joint Commission, AAAHC, CMS, or other regulatory standards)
Review and analyze credentialing applications and supporting documents for accuracy and completeness
Validate and verify provider credentials (licensure, DEA, specialty board, certificates, professional liability, and other required documents) through the appropriate verification sources
Identify discrepancies in information, conducting research and follow-up, and escalate unresolved issues
Complete payor provider enrollment process, performing revalidations, maintaining CAQH profiles, NPPES registrations, provider data with payers and managing plan enrollment status in credentialing system
Other duties as assigned

Requirements

What you’ll need

Minimum of three (3) years of progressive experience in Provider Enrollment, 5+ years preferred
In-depth knowledge of Provider enrollment standards (HRSA, FTCA, TJC, NCQA, etc.) preferred
Certified Provider Credentialing Specialist (CPCS) may be required or strongly preferred (Must be NAMSS not AAPC)
Proficiency in credentialing software and data management systems is preferred
Experience with New York payers preferred
Experience in MD-Staff preferred
Advanced Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, etc.) preferred
Working knowledge of Smartsheet including data structure, formula creation, basic workflows and automation preferred
Proven experience in client-facing roles, with the ability to build strong relationships and communicate effectively with diverse stakeholders preferred
Familiarity with Jira for issue tracking and task management preferred

Benefits

Comp & perks

Comprehensive range of benefits
Health insurance
Retirement plans
Paid time off
Flexible working arrangements
Professional development opportunities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

provider enrollmentcredentialingdata managementverification of credentialsregulatory compliancecredentialing applicationspayor enrollmentrecredentialingdiscrepancy identificationdata analysis

Soft Skills

relationship buildingcommunicationproblem-solvingresearchfollow-upclient-facing experienceattention to detailorganizational skillsescalation of issuescollaboration

Certifications

Certified Provider Credentialing Specialist (CPCS)