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Provider Enrollment Credentialing Jobs (NOW HIRING)

Communicarehealth

This specialist reviews claim denials related to healthcare payer enrollment/credentialing and contracting to increase revenue for their assigned providers. Responsibilities Include: * Develop and ...

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Provider Enrollment Credentialing information

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How much do provider enrollment credentialing jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for provider enrollment credentialing in the United States is $24.36, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $27.64 per hour, depending on experience, location, and employer.

What is provider enrollment credentialing?

Provider enrollment credentialing is the process by which healthcare professionals and organizations are verified and approved to participate with insurance plans, government programs, and other payers. It involves collecting and validating information such as education, licenses, certifications, and work history to ensure providers meet specific standards. This process helps maintain the quality of care and compliance with regulations. Credentialing is essential for providers to be reimbursed for services and to ensure patient safety. The process can be lengthy and requires continual updates to maintain participation.

What are some common challenges faced in a Provider Enrollment Credentialing role, and how can they be addressed?

One of the main challenges in Provider Enrollment Credentialing is managing complex and ever-changing payer requirements, which can vary significantly between insurance companies and states. This often requires strong organizational skills and meticulous attention to detail to ensure timely and accurate submission of documentation. Effective communication with providers and payers is essential to resolve discrepancies quickly. Staying up-to-date with regulatory changes and maintaining a well-organized tracking system can help address these challenges and ensure a smoother credentialing process.

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

AspectProvider Enrollment CredentialingProvider Enrollment Specialist
Primary RoleVerifies provider credentials, licenses, and certifications for insurance enrollmentManages the enrollment process, submits applications, and maintains provider records
Required CredentialsLicenses, certifications, and credentialing documentsKnowledge of enrollment procedures and documentation
Work EnvironmentHealthcare organizations, credentialing companiesInsurance companies, healthcare provider offices

Provider Enrollment Credentialing focuses on verifying provider qualifications, while Provider Enrollment Specialists handle the application process and ongoing enrollment management. Both roles are essential in ensuring providers are properly credentialed and enrolled with insurance plans.

What are the key skills and qualifications needed to thrive as a Provider Enrollment Credentialing Specialist, and why are they important?

To thrive as a Provider Enrollment Credentialing Specialist, you need strong attention to detail, organizational skills, and a solid understanding of healthcare compliance and credentialing regulations, often supported by a relevant associate's or bachelor's degree. Familiarity with credentialing software, provider databases, and systems like CAQH, as well as knowledge of payer enrollment processes, is typically required. Excellent communication, problem-solving abilities, and the capacity to manage multiple tasks efficiently are standout soft skills in this role. These skills ensure accurate and timely provider enrollment, compliance with regulatory standards, and smooth healthcare operations.
More about Provider Enrollment Credentialing jobs
What cities are hiring for Provider Enrollment Credentialing jobs? Cities with the most Provider Enrollment Credentialing job openings:
What states have the most Provider Enrollment Credentialing jobs? States with the most job openings for Provider Enrollment Credentialing jobs include:
What job categories do people searching Provider Enrollment Credentialing jobs look for? The top searched job categories for Provider Enrollment Credentialing jobs are:
Provider Enrollment Credentialing jobs near you
Infographic showing various Provider Enrollment Credentialing job openings in the United States as of June 2026, with employment types broken down into 61% Full Time, 28% Part Time, and 11% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $50,665 per year, or $24.4 per hour.

Provider Enrollment & Credentialing Specialist

Pinnacle Wound Management

Miami, FL

$75K - $325K/yr

Full-time

Posted 24 days ago

Job description


Job Title: Provider Enrollment & Credentialing Specialist
Company: Pinnacle Wound Management
Location: Gainesville, GA
Employment Type: Full-Time



About Us:
At Pinnacle Wound Management, we are dedicated to improving the lives of patients through high-quality wound care delivered by expert physicians, nurse practitioners, and physician assistants. As a growing leader in this specialized healthcare field, we’re looking for a detail-oriented and proactive Provider Enrollment & Credentialing Specialist to support our expanding clinical team.



Position Overview:
The Provider Enrollment & Credentialing Specialist will be responsible for the full-cycle credentialing and enrollment of our healthcare providers, including physicians and mid-level practitioners. This role is vital to ensuring that our clinical staff are enrolled with payers, credentialed with facilities, and compliant with all regulatory and operational standards.


Key Responsibilities:

  • Manage the credentialing and re-credentialing processes for physicians, nurse practitioners, and physician assistants.

  • Enroll new providers with Medicare, Medicaid, and commercial insurance plans.

  • Maintain accurate and up-to-date provider information in internal databases and with payer systems.

  • Track expirables (e.g., licenses, certifications, malpractice insurance) and ensure timely renewals.

  • Communicate with providers and internal departments to gather necessary documentation and resolve enrollment or credentialing issues.

  • Monitor and respond to payer requests and follow up to ensure timely processing.

  • Stay current on enrollment and credentialing regulations and payer requirements.

  • Support facility privileging processes when applicable.

Qualifications:

  • 2+ years of experience in healthcare credentialing and/or provider enrollment.

  • Familiarity with CAQH, PECOS, NPPES, and commercial insurance enrollment processes.

  • Strong organizational skills and attention to detail.

  • Ability to work independently and manage multiple tasks and deadlines.

  • Excellent communication skills, both written and verbal.

  • Experience in wound care or with mobile healthcare providers is a plus.

Preferred Skills:

  • Knowledge of credentialing software and platforms.

  • Experience working with a geographically distributed provider team.

  • Understanding of state licensing requirements and compliance standards.

Why Join Us?

  • Opportunity to be part of a mission-driven team making a direct impact on patient care.

  • Supportive and collaborative work environment.

  • Competitive salary and benefits package.