Provider Enrollment & Credentialing Specialist
Listed on 2026-01-01
-
Healthcare
Healthcare Administration, Medical Billing and Coding
Gainesville, United States | Posted on 11/30/2025
Employment TypeFull
- Time
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 OverviewThe 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.
- 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.
- Knowledge of credentialing software and platforms.
- Experience working with a geographically distributed provider team.
- Understanding of state licensing requirements and compliance standards.
- 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.
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