Enter and maintain all Provider information into credentialing database. * Verify potential and ... Keep up to date provider enrollment process and records and track provider participation levels.
Enter and maintain all Provider information into credentialing database. * Verify potential and ... Keep up to date provider enrollment process and records and track provider participation levels.
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 ...
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 ...
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 ...
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 ...
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 ...
New
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 ...
New
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 ...
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 ...
Enter and maintain all Provider information into credentialing database. * Verify potential and ... Keep up to date provider enrollment process and records and track provider participation levels.
Enter and maintain all Provider information into credentialing database. * Verify potential and ... Keep up to date provider enrollment process and records and track provider participation levels.
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
We are presently seeking a second Credentialing & Provider Enrollment Specialist at GPHA's Executive Offices located at Carl Moore Health Center in Southwest Philadelphia. Hybrid work schedule is ...
Quick apply
We are presently seeking a second Credentialing & Provider Enrollment Specialist at GPHA's Executive Offices located at Carl Moore Health Center in Southwest Philadelphia. Hybrid work schedule is ...
A Medicaid Provider Enrollment Subject Matter Expert (SME) ensures healthcare providers are properly credentialed, contracted, and enrolled in government-sponsored health plans. Responsibilities ...
A Medicaid Provider Enrollment Subject Matter Expert (SME) ensures healthcare providers are properly credentialed, contracted, and enrolled in government-sponsored health plans. Responsibilities ...
Provides assistance and support to the Credentialing Supervisor with the day to day operations and functions of payer enrollment. Responsibilities: * Assists in the management and successful ...
Provides assistance and support to the Credentialing Supervisor with the day to day operations and functions of payer enrollment. Responsibilities: * Assists in the management and successful ...
Provides assistance and support to the Credentialing Supervisor with the day to day operations and functions of payer enrollment. Responsibilities: * Assists in the management and successful ...
Provides assistance and support to the Credentialing Supervisor with the day to day operations and functions of payer enrollment. Responsibilities: * Assists in the management and successful ...
Nira's mission is to enable clinicians to provide access to life-changing treatments so you can ... The Enrollment & Credentialing Coordinator plays a critical role in ensuring Nira Medical ...
Nira's mission is to enable clinicians to provide access to life-changing treatments so you can ... The Enrollment & Credentialing Coordinator plays a critical role in ensuring Nira Medical ...
Provider Enrollment Specialist
Hollywood, FL · On-site
$22 - $25/hr
Our Provider Enrollment Specialist provides overall support to the Director of Payor Contracting ... Manage the enrollment/credentialing process from start to finish including obtaining applications ...
Provider Enrollment Specialist
Hollywood, FL · On-site
$22 - $25/hr
Our Provider Enrollment Specialist provides overall support to the Director of Payor Contracting ... Manage the enrollment/credentialing process from start to finish including obtaining applications ...
We are presently seeking a second Credentialing & Provider Enrollment Specialist at GPHA's Executive Offices located at Carl Moore Health Center in Southwest Philadelphia. Hybrid work schedule is ...
Quick apply
We are presently seeking a second Credentialing & Provider Enrollment Specialist at GPHA's Executive Offices located at Carl Moore Health Center in Southwest Philadelphia. Hybrid work schedule is ...
Summary of Job Responsible for preparing provider enrollment applications, demographic updates and ... Maintain up-to-date data for each provider in credentialing databases and online systems; ensure ...
Summary of Job Responsible for preparing provider enrollment applications, demographic updates and ... Maintain up-to-date data for each provider in credentialing databases and online systems; ensure ...
Summary of Job Responsible for preparing provider enrollment applications, demographic updates and ... Maintain up-to-date data for each provider in credentialing databases and online systems; ensure ...
Summary of Job Responsible for preparing provider enrollment applications, demographic updates and ... Maintain up-to-date data for each provider in credentialing databases and online systems; ensure ...
Summary of Job Responsible for preparing provider enrollment applications, demographic updates and ... Maintain up-to-date data for each provider in credentialing databases and online systems; ensure ...
Summary of Job Responsible for preparing provider enrollment applications, demographic updates and ... Maintain up-to-date data for each provider in credentialing databases and online systems; ensure ...
Overview Preference to candidates with ENROLLMENT, CREDENTIALING, and/or BILLING experience. As a ... EO/AA The Provider Enrollment Specialist is responsible for obtaining and coordinating all ...
Overview Preference to candidates with ENROLLMENT, CREDENTIALING, and/or BILLING experience. As a ... EO/AA The Provider Enrollment Specialist is responsible for obtaining and coordinating all ...
Provider Enrollment Credentialing information
See salary details
$13.70 - $16
2% of jobs
$16 - $18.29
13% of jobs
$19.44 is the 25th percentile. Wages below this are outliers.
$18.29 - $20.59
20% of jobs
The median wage is $22.59 / hr.
$20.59 - $22.88
17% of jobs
$22.88 - $25.17
15% of jobs
$26.90 is the 75th percentile. Wages above this are outliers.
$25.17 - $27.47
11% of jobs
$27.47 - $29.76
10% of jobs
$29.76 - $32.06
5% of jobs
$32.06 - $34.35
3% of jobs
$34.35 - $36.65
3% of jobs
$36.65 - $38.94
1% of jobs
$13
$24
$38
How much do provider enrollment credentialing jobs pay per hour?
As of Jul 5, 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?
| Aspect | Provider Enrollment Credentialing | Provider Enrollment Specialist |
|---|---|---|
| Primary Role | Verifies provider credentials, licenses, and certifications for insurance enrollment | Manages the enrollment process, submits applications, and maintains provider records |
| Required Credentials | Licenses, certifications, and credentialing documents | Knowledge of enrollment procedures and documentation |
| Work Environment | Healthcare organizations, credentialing companies | Insurance 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:
- Credentialing And Provider Enrollment Coordinator
- Medicare Provider Enrollment Analyst
- Urgently Hiring Payer Enrollment Specialist
- Credentialing Provider Enrollment Manager
- Medical Staff Credentialing Manager
- Senior Specialist Caqh
- Evening Payer Enrollment Specialist
- Seasonal Payer Enrollment Specialist
- From Home Payer Enrollment Specialist
- Eft Era Enrollment
DentaQuest rating
7.1
Based on 7 frontline employees who took The Breakroom Quiz
227th of 277 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.
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.
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.
About DentaQuest
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Boston, MA, US
Year founded
2001