About the Role

The Contracts & Credentialing Coordinator is responsible for supporting provider enrollment, credentialing, contracting, and payer-related activities to ensure providers are accurately enrolled, credentialed, and maintained with commercial and government payers. This position works closely with providers, insurance carriers, healthcare facilities, and internal teams to ensure timely completion of all credentialing and contracting processes.

Responsibilities

• Process and submit provider credentialing and contracting applications with commercial and government payers.
• Conduct all required follow-up activities until payer approval or completion is obtained.
• File provider practice change notifications and ensure completion with applicable payers.
• Update and maintain provider and facility NPI records.
• Enroll providers in Medicare, Medicaid, and commercial insurance networks.
• Maintain provider records within CAQH and ensure timely attestations and updates.
• Track provider licenses, board certifications, DEA registrations, and expiration dates.
• Complete provider and facility recredentialing requests and follow-up activities.
• Process requests from payers regarding credentialing updates, new contracts, and provider information.
• Research and resolve enrollment discrepancies involving providers and facilities.
• Complete and maintain ERA, EFT, EDI, and clearinghouse enrollments.
• Manage provider access and maintenance within Availity, Optum, Medicare portals, and other credentialing platforms.
• Submit accreditation applications and manage follow-up through approval.
• Complete licensing applications and renewals across multiple states when required.
• Create and maintain Group NPI (GNPI) and Individual NPI (INPI) records through NPPES.
• Submit and track hospital privilege and initial appointment applications.
• Submit and track DEA applications and renewals.
• Maintain accurate documentation and status tracking for all credentialing and contracting activities.
• Serve as a liaison between providers, payers, healthcare facilities, and internal departments.
• Support special projects related to provider enrollment, credentialing validation, and network participation.

Qualifications

• 1–3 years of experience in Contracting, Credentialing, Provider Enrollment, or related healthcare administration functions.
• Working knowledge of provider credentialing and payer enrollment processes.
• Strong verbal and written communication skills.
• Excellent organizational and time management abilities.
• Strong attention to detail and accuracy.
• Ability to identify, track, and resolve issues independently.
• Ability to work in a fast-paced, deadline-driven environment.
• Ability to work effectively in a fully remote environment.
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook, Teams).
• Experience working with healthcare providers, payers, and credentialing organizations.

Skills and Abilities

• Strong organizational and prioritization skills.
• Ability to work independently with minimal supervision.
• Ability to manage multiple projects and deadlines simultaneously.
• Strong problem-solving and critical-thinking abilities.
• Excellent customer service and relationship-building skills.
• Ability to communicate professionally with providers, payers, and internal stakeholders.
• Proficiency in Microsoft Office Suite, particularly Excel and Outlook.
• Knowledge of healthcare credentialing, provider enrollment, and payer contracting processes.
• Knowledge of medical terminology and revenue cycle processes is a plus.
• Experience with CAQH, Availity, Medicare, Medicaid, Optum, EnrollHub, or similar systems is preferred.
• Experience with Modio, Pipedrive, and LastPass is a plus.
• Contract negotiation and payer contracting experience is a plus.
• Bilingual skills are a plus.

Required Experience

• 1–3 years of experience in provider credentialing, enrollment, contracting, or healthcare operations.
• Experience processing Medicare, Medicaid, and commercial payer enrollments.
• Experience maintaining CAQH profiles and provider records.
• Experience working with payer portals and insurance carrier systems.
• Experience submitting and tracking provider credentialing and recredentialing applications.
• Experience managing multiple provider records and deadlines simultaneously.
• Experience within a multi-provider healthcare organization preferred.
• Plastic Surgery, Dermatology, or specialty medical practice experience is a plus.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions.

• Regularly required to sit and communicate using a computer and telephone.
• Regularly required to use hands and fingers to operate office equipment.
• Frequently required to reach with hands and arms.
• Ability to view and work on a computer monitor for extended periods.
• Ability to maintain focus and accuracy when reviewing detailed documentation.

Work Environment

This position operates in a fully remote work environment.

• Standard office equipment is required, including a computer, headset, internet connection, phone system, and related software applications.
• Employee must maintain a reliable internet connection and workspace that supports productivity and confidentiality.

Preferred Candidate Profile

• Strong experience with provider enrollment and credentialing.
• Comfortable handling high-volume payer follow-ups.
• Highly organized and process-driven.
• Able to manage multiple providers and projects simultaneously.
• Demonstrates ownership, accountability, and attention to detail.
• Strong communicator with providers, insurance carriers, and internal stakeholders.
• Experience working in a healthcare revenue cycle or medical billing environment is highly preferred.