Network Provider Enrollment Specialist

Network Provider Enrollment Specialist
PayerCredentialing Department
Exceed Healthcare

Why join Exceed Healthcare?

At Exceed Healthcare, our mission is simple: improving lives through innovation. We are redefining healthcare by delivering cutting-edge medical services, expanding access through seamless virtual care, and always putting patients at the center of everything we do.

Our vision is to lead the future of healthcare by exceeding expectations through technology, strategic insight, and a deep commitment to excellence.

We value integrity, respect, accountability, and collaboration. We foster a diverse and inclusive culture where courage and resiliency thrive—and where every team member plays a vital role in making an impact.

Join us to be part of a forward-thinking team that prioritizes exceptional patient care, supports your growth, and believes in leading from every role.

Exceed Offers:

• Medical, Dental, & Vision Benefits

• Personal Time Off

• Retirement Plan

  • Exceed offers a company math of up to 4% to help contribute to your retirement.

• Employee Growth

  • Exceed values internal promotion and encourages employees to reach their career growth goals.

• Exceed Training

  • Exceed prioritizes the development of our employees by offering a variety of workshops and training programs designed to foster their personal growth and advance their careers.

• Competitive Pay

  • Exceed continuously monitors market evaluations to maintain its position as a leading competitor in the industry.

• Work/Life Balance

  • Exceed recognizes that you have a life beyond your job. We prioritize creating a balanced work schedule for our providers, enabling them to maintain a harmonious life at home as well.

Job Summary:

The Payer Credentialing Specialist at Exceed Healthcare is responsible for managing the credentialing and enrollment processes for clients of Exceed Healthcare. This includes maintaining accurate provider data, submitting and tracking enrollment applications, ensuring compliance with payer requirements, and monitoring certifications and licensure. The role involves close collaboration with insurance payers, external vendors, and internal teams to resolve credentialing issues and ensure timely processing. The specialist will also manage provider information in credentialing databases and ensure all data is current and accurate.

Requirements:

Education & Experience:

• High school diploma or equivalent required; associate or bachelor’s degree in healthcare, business, or related field preferred.

• Minimum of 1-2 years of experience in payer credentialing, medical staff services, or healthcare administration.

• Previous experience working with insurance payers, networks, and credentialing software is a plus.

• Certified Provider Credentialing Specialist (CPCS) or similar credentialing certification (optional, but preferred)

• Membership in professional organizations such as the National Association of Medical Staff Services (NAMSS) is a plus.
  

Knowledge & Skills:

• Strong understanding of insurance payer requirements and credentialing processes.

• Familiarity with various credentialing databases (e.g., CAQH, PECOS, etc.) and healthcare industry standards.

• Proficient in Microsoft Office Suite (Excel, Word, Outlook) and Gsuite.

• Excellent attention to detail and accuracy.

• Strong organizational and time-management skills with the ability to prioritize multiple tasks.

• Knowledge of federal and state regulations regarding provider credentialing (e.g., HIPAA, NCQA, CMS).

• Proven time management and prioritization skills focusing on urgent and overlapping deadlines

We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.