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Provider Enrollment Credentialing Jobs (NOW HIRING)

e-MDs

Credentialing Specialist

Hauppauge, NY · Remote

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 ...

NorthBay Health

Provider Enrollment Analyst

Fairfield, CA · On-site

$38.09 - $46.32/hr

The position is responsible for enrollment, credentialing and termination of NorthBay physicians/providers with NorthBay's contracted health plan partners. This position maintains rosters and ...

e-MDs

Credentialing Specialist

Hauppauge, NY · On-site

Summary of Job Responsible for preparing provider enrollment applications, demographic updates and ... Reports to Director of Credentialing and CVO. Essential Duties and Responsibilities • Provides ...

e-MDs

Credentialing Specialist

Hauppauge, NY · On-site

Summary of Job Responsible for preparing provider enrollment applications, demographic updates and ... Reports to Director of Credentialing and CVO. Essential Duties and Responsibilities • Provides ...

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Provider Enrollment Credentialing information

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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?

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 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $50,665 per year, or $24.4 per hour.
Provider Enrollment Analyst

Provider Enrollment Analyst

NorthBay Health

Fairfield, CA • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

NorthBay Health rating

8.5

Company rating: 8.5 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

Job Description
At NorthBay Health, the Provider Enrollment analyst is responsible for all Medical Staff and Allied Health Practitioner (AHP) heal plan credentialing and recredentialing with government and commercial health plans. The position is responsible for enrollment, credentialing and termination of NorthBay physicians/providers with NorthBay's contracted health plan partners. This position maintains rosters and functionality that support a compliant provider enrollment process. Additional role responsibilities include compiling and distributing periodic reports, both within the department and throughout the organization as well as investigating and resolving provider enrollment issues. Servies as a resource related to the National Committee for Quality Assurance (NCQA).
PRIMARY JOB DUTIES
  1. Responsible for all enrollment functions, credentialing and termination of providers and select contracted specialists.
  2. Serves as a resource in credentialing standards for NCQA, CMS, Medi-Cal, medical group affiliates and health plans.
  3. Monitors current regulations and enrollment guidelines for payers of all current and future healthcare services.
  4. Proficient in PECOS, PAVE, CAQH, Better Doctors, MD-Staff and other credentialing and enrollment software and websites, and other tools required to enroll, credential and terminate providers.
  5. Coordinates assigned enrollment activities and tracks progress toward established timelines.
  6. Provides enrollment information and support to Administration (Department Directors, Managers, Supervisors), medical staff and hospital personnel in all activities related to provider health plan credentialing requirements.
  7. Responsible for maintaining databases with Medical Staff that support the health plan enrollment functions.
  8. Collaborates with Revenue Cycle to correct any payment deficiencies due to health plan enrollment.
  9. Track, document, communicate, and escalate provider enrollment issues timely and appropriately to department leadership or other stakeholders.
  10. Cross trains with other department Analysts to assist with various system maintenance, updates, etc.
  11. Enhances professional growth and development through educational programs or seminars.
  12. Maintain effective working partnerships internally and externally to support provider enrollment efforts.
  13. Works independently utilizing a high level of initiative, judgement and critical thinking skills.
Qualifications
  1. Licensure/Certification: NCQA health plan accreditation training preferred.
  2. Experience: Minimum 5 years of experience in a corporate business setting, preferably in a health care setting.
  3. Skills: Excellent oral and written communications skills. Must possess teaching ability and demonstrate the ability to efficiently collaborate with others. Capable of communicating effectively at all levels of the organization. Ability to work on multiple projects simultaneously and manage deadlines. Must be highly organized with the ability to set priorities, work independently and be an effective team member. Ability to integrate information from multiple sources into an automated process to effectively manage provider health plan enrollment. Advanced computer skills to include: Microsoft Windows and Office suite, Access, MD Staff, Tableau and other on-line enrollment systems.
  4. Interpersonal Skills: Demonstrates the True North values. The True North values are a set of value-based behaviors that are to be consistently demonstrated and role modeled by all employees that work at NorthBay Health. The True North values principles consist of Nurture/Care, Own It, Respect Relationships, Build Trust and Hardwire Excellence.Requires ability to communicate effectively verbally and in writing, good presentation skills, team building, and educational teaching skills.
  5. Hours of Work: Non-exempt. Normally works eight-hour day. Hours will vary according to work demands and project requirements.

About Us
Interpersonal Skills and Values
Demonstrates NorthBay Health's True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care.
Why NorthBay Health
NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.
We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions.
We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities.
NorthBay Health Benefits Options
NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance.
Compensation Structure
NorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1-5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements.
Remote Work Disclosure
NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs.
Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States.
Notice to Recruitment Agencies
NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings.
More Information
Visit NorthBay Health Careers for recruitment FAQs and additional information.

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