Insurance Contracting
Manage the full lifecycle of insurance payer contracts including initiation, negotiation coordination, submission, and maintenance
Maintain relationships and communication with insurance companies and payer representatives
Track contract statuses, effective dates, renewals, and amendments
Ensure accurate documentation of all payer agreements
Provider Credentialing
Prepare and submit credentialing and recredentialing applications for providers with commercial and government payers
Maintain provider profiles in credentialing systems such as CAQH and PECOS
Track application progress and follow up with payers to ensure timely approvals
Maintain accurate credentialing files for all providers
Compliance & Documentation
Monitor license renewals, certifications, malpractice insurance, and other compliance requirements
Ensure providers remain in good standing with all regulatory and payer requirements
Maintain organized credentialing and contracting records for audits and regulatory reviews
Assist with internal and external compliance audits when necessary
Updates & Maintenance
Maintain provider demographic and credentialing data across internal systems and payer portals
Process updates related to provider information, locations, and services
Ensure payer directories and internal records remain accurate and current
Cross-Department Collaboration
Work closely with billing, operations, and leadership teams to ensure providers are properly enrolled for billing
Provide status updates on credentialing and contracting processes
Support the onboarding of new providers
2+ years of experience in healthcare credentialing and insurance contracting
Strong knowledge of payer enrollment, CAQH, and credentialing processes
Familiarity with Medicare, Medicaid, and commercial payer requirements
Excellent organizational and documentation skills
Strong communication and follow-up abilities
Proficiency with credentialing databases and Microsoft Office