Provider Enrollment & Credentialing Specialist
Listed on 2025-12-09
-
Healthcare
Healthcare Administration, Medical Billing and Coding, Healthcare Compliance, Medical Office
Miami, 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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