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Credentialing Provider Enrollment Manager Jobs (NOW HIRING)

MDVIP LLC

Provider Enrollment Manager

Boca Raton, FL · On-site

This role requires deep expertise in credentialing and contracting, along with the ability to ... The Provider Enrollment Manager partners closely with internal leadership to manage high-impact ...

New

MDVIP LLC

Provider Enrollment Manager

Boca Raton, FL · On-site

This role requires deep expertise in credentialing and contracting, along with the ability to ... The Provider Enrollment Manager partners closely with internal leadership to manage high-impact ...

New

Pediatrix

Provider Enrollment Specialist

The Provider Enrollment Specialist II will assist Management in maintaining provider enrollment ... Documents assignments in the Credentialing/Provider Enrollment tracking system per the department ...

Pediatrix

Provider Enrollment Specialist

The Provider Enrollment Specialist II will assist Management in maintaining provider enrollment ... Documents assignments in the Credentialing/Provider Enrollment tracking system per the department ...

Alegis

Provider Enrollment Manager

Brecksville, OH · On-site

Manage provider enrollment team resources and workflow to reach maximum efficiency and productivity levels, as well as provide solutions on how to improve in this area. * Participate and ensure ...

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How much do credentialing provider enrollment manager jobs pay per year?

As of Sep 6, 2026, the average yearly pay for credentialing provider enrollment manager in the United States is $85,031.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,000.00 and $94,500.00 per year, depending on experience, location, and employer.

What is a credentialing provider enrollment manager?

A Credentialing Provider Enrollment Manager is a professional responsible for overseeing the process of verifying healthcare providers’ qualifications and enrolling them with insurance payers and government programs. They ensure that all providers meet the necessary standards and maintain compliance with regulatory and organizational requirements. Their role includes managing documentation, coordinating with providers and payers, and staying up to date with changes in credentialing and enrollment policies. This position is essential for healthcare organizations to ensure that providers are authorized to deliver services and receive reimbursement.

What are the key skills and qualifications needed to thrive as a credentialing provider enrollment manager, and why are they important?

To thrive as a Credentialing Provider Enrollment Manager, you need in-depth knowledge of healthcare regulations, credentialing standards, and provider enrollment processes, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with credentialing software (such as CAQH or Verity), database management, and understanding of payer requirements are typically essential. Exceptional organizational skills, attention to detail, and strong communication abilities help in managing complex documentation and facilitating provider relations. These competencies ensure accurate, timely provider onboarding and regulatory compliance, which are critical for uninterrupted patient care and organizational success.

What are some common challenges faced by a credentialing provider enrollment manager, and how can they be addressed?

Credentialing Provider Enrollment Managers often encounter challenges such as managing tight deadlines for provider onboarding, navigating complex payer requirements, and ensuring compliance with ever-changing regulations. Maintaining clear communication with providers and payers, staying updated on industry standards, and implementing robust tracking systems can help address these issues effectively. Regular training for staff and fostering a collaborative team environment are also key strategies for overcoming these challenges and ensuring smooth enrollment processes.

What is the difference between Credentialing Provider Enrollment Manager vs Credentialing Specialist?

AspectCredentialing Provider Enrollment ManagerCredentialing Specialist
CertificationsOften requires industry certifications like CPCS or CPMSMMay hold certifications such as Certified Provider Credentialing Specialist
Work EnvironmentManages teams, oversees enrollment processes, interacts with payersPerforms credentialing tasks, verifies provider information, processes applications
Employer & Industry UsageUsed in healthcare organizations, insurance companies, and credentialing firmsCommonly employed in healthcare facilities, billing companies, and credentialing departments

The Credentialing Provider Enrollment Manager typically oversees the entire provider enrollment process, managing teams and strategic planning. In contrast, the Credentialing Specialist focuses on executing credentialing tasks and verifying provider credentials. Both roles are essential in healthcare credentialing but differ in scope and responsibilities.

More about Credentialing Provider Enrollment Manager jobs

What cities are hiring for Credentialing Provider Enrollment Manager jobs?

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What are the most commonly searched types of Credentialing Provider Enrollment jobs?

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What states have the most Credentialing Provider Enrollment Manager jobs?

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Credentialing Provider Enrollment Manager jobs near you
Infographic showing various Credentialing Provider Enrollment Manager job openings in the United States as of August 2026, with employment types broken down into 87% Full Time, 12% Part Time, and 1% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $85,031 per year, or $40.9 per hour.

Credentialing & Provider Enrollment Specialist

TEXAS HEARING INSTITUTE

Houston, TX • On-site

$23 - $25/hr

Full-time

Posted 29 days ago

Job description

Job Title: Credentialing & Provider Enrollment Specialist
Supervisor: Business Office Director
Texas Hearing Institute (THI) | Houston, TX (On-site)
Schedule: Monday - Thursday: 7:30 am - 5:30 pm Friday: 7:30 am - 3:00 pm 40 hours/week
Compensation: $23-$25
About Us
Texas Hearing Institute is a Houston-based nonprofit dedicated to serving individuals with hearing loss. Our programs include audiology, speech therapy, family services, and the Melinda Webb School. The Business Office team supports all of these programs by keeping operations running smoothly and the organization's billing and credentialing accurate.
Position Summary
We are looking for an experienced Credentialing & Provider Enrollment Specialist to oversee all aspects of provider credentialing, enrollment, recredentialing, payer contracting support, and regulatory compliance. This position serves as the primary liaison between THI, providers, and commercial and government payers to ensure providers remain credentialed, enrolled, and eligible for reimbursement. This role will provide front desk coverage only as needed to support departmental operations.
What You Will Do
  • Complete initial credentialing and recredentialing for all providers.

  • Submit and monitor provider enrollment applications.

  • Maintain provider files and credentialing documentation.

  • Maintain CAQH, PECOS, TMHP/PEMS, and other payer portals.

  • Track expiration dates for: Medical licenses/ DEA registrations/ Board certifications/ Professional liability insurance/ CPR certifications (if applicable)

  • Recredentialing cycles

  • Follow up with payers until providers are confirmed in-network.

  • Maintain provider enrollment status reports.

  • Ensure compliance with payer enrollment requirements.

  • Assist with provider contracting activities.

  • Coordinate payer participation requests.

  • Maintain contract documentation.

  • Monitor provider participation status.

  • Communicate enrollment or contracting issues to leadership.

  • Monitor credentialing and enrollment timelines.

  • Identify providers approaching expiration or termination.

  • Prepare weekly credentialing reports.

  • Maintain accurate documentation for audits.

  • Maintain confidentiality in accordance with HIPAA regulations.

What We're Looking For
  • High school diploma or equivalent required; associate or bachelor degree preferred

  • Minimum 2 years of provider credentialing and enrollment managed care plan, medical Staff Services, or credentialing verification office.

  • Working knowledge of Texas Medicaid (TMHP/PEMS), Medicare (PECOS), CHIP, and commercial payer enrollment requirements.

  • Experience maintaining CAQH provider profiles.

  • Basic understanding of credentialing Joint Commission, NCQA, and URAC accreditation standards

  • Working knowledge of provider contracting and payer enrollment processes.

  • Understanding of healthcare regulatory and compliance standards.

  • Strong organizational and follow-up skills

Schedule and Compensation
  • Monday - Thursday: 7:30 am - 5:30 pm/ Friday: 7:30 am - 3:00 pm

  • $23-$25/hr

Please visit our careers page to see more job opportunities.

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