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Provider Enrollment Credentialing Jobs (NOW HIRING)

UMR

Provider Enrollment & Credentialing Specialist

Boston, MA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Serves as the primary person to ensure accuracy and timing of the entire provider enrollment/credentialing process from the time that the provider submits the credentialing or change information to ...

QUANTERIX CORP

Payor Enrollment & Credentialing

$80K - $100K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Provide updates to internal teams on credentialing and enrollment status. BASIC QUALIFICATIONS: * Bachelor's degree required. * 5+ years of experience in payor enrollment, credentialing, revenue ...

New

IntePros

Enrollment Specialist

Philadelphia, PA · On-site

This role is responsible for ensuring providers are accurately enrolled with commercial and government payers, maintaining credentialing records, and monitoring licensure and certification compliance ...

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Provider Enrollment Credentialing information

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How much do provider enrollment credentialing jobs pay per hour?

As of Aug 16, 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?

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 August 2026, with employment types broken down into 3% As Needed, 77% Full Time, 14% Part Time, and 6% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $50,665 per year, or $24.4 per hour.

Provider Enrollment Credentialing Specialist

Dentaquest

Grafton, WI • On-site

Full-time

Re-posted 25 days ago

DentaQuest rating

5.2

Company rating: 5.2 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

296th of 308 rated insurance

Job description

Primary responsibilities include taking a new provider application from receipt to inclusion on directory along with ongoing updates. This includes accurate and timely entry of provider data including provider applications and contract information, status changes, payee changes, verifying all the credentialing criteria for practitioners that have applied to the network, including both initial and re-credentialing and follow up with practitioners as needed to obtain information for the credentialing process or as a result of mail being returned undeliverable to DentaQuest.
JOB DUTIES AND RESPONSIBILITIES:
  • Enter and maintain Provider applications, contracts and updates into the system.
  • Enter and maintain all Provider information into credentialing database.
  • Verify potential and existing Provider's licensure, liability insurance, BNDD, CDS and DEA certificate.
  • Verify Provider's education, hospital privileges, Board certification and other criteria as required.
  • Verify accurate banking & billing information.
  • Perform ongoing research tocorrect data so it does not create duplicate provider, locations, payees, and participations.
  • Maintain credentialing information by reviewing, entering and following up on missing information.
  • Review National Practitioners Data Bank for adverse charges pending or filed against Provider.
  • Track contract applications status.
  • Assure all files have a Welcome, Denial or Term Letter as appropriate.
  • Meet required turnaround times and accuracy rates.
  • Maintain fee schedules by creating, reviewing and auditing provider fees.
  • Keep up to date provider enrollment process and records and track provider participation levels.
  • Facilitate provider related research based on suspended claims, PO returns and other feedback opportunities.
  • Participation in credentialing committee as necessary.
  • Update the system and the credentialing database to reflect approvals, denials and/ or terminations.
  • Assist with other duties as assigned.

Skills & Requirements
JOB REQUIREMENTS:
  • High School diploma or equivalent, Associate's degree preferred.
  • 1-2 years of experience in business environment.
  • Previous experience working with files or the collection and coordination of data preferred.
  • Proficient in the use Excel required.
  • Experience with general computer software (Word, Outlook required).
  • Ability to learn new software programs quickly.
  • Good basic math skills.
  • Excellent customer service skills.
  • Excellent verbal and written communication skills.
  • Professional and effective interaction skills with co-workers, clients, Providers, vendors.
  • Proven ability to work well individually and as a team member.
  • Ability to prioritize and organize multiple tasks.
  • Ability to remain organized with multiple interruptions.
  • Ability to make independent decisions.
  • Strong attention to detail.
  • Strong business acumen.
  • Ability to adapt to constantly changing environment.
  • Ability to work in excess of 40 hours.

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Careers
As one of the nation's leading oral health companies, we direct all our energy and resources to improving oral health in the communities we serve. We depend on our people for our ability to provide the highest-quality benefit programs and superior customer service. If you're looking for a challenging work environment where you will be asked to continually develop your skills, you've found the right place.
We are a growing, financially sound company with many advantages to offer to our employees. In addition to competitive salaries and a great benefits package, we also offer a stimulating, productive work environment. Work-life balance is a reality at DentaQuest, as is our commitment to our employees' career advancement.
DentaQuest is an equal opportunity employer. We believe that your work history is the best measure of the value you will bring to the company. We do not base any employment decision on a person's race, religion, color, national origin, gender, sexual preference, marital status, age, veteran status, or disability unrelated to the ability to do the job.
Thank you for visiting. We are delighted that you are considering joining our team of dedicated oral health professionals.

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