Payer Enrollment & Credentialing Specialist

100% Remote

Please Apply Only If You Have 3 Years Experience Completing Medicare and Medicaid Payer Credentialing Applications

Join AIS Healthcare

Why Join AIS Healthcare?

• 100% Remote Work Opportunity
• Medical, Dental, and Vision Insurance
• Company-Paid Life Insurance
• Long-Term Disability Insurance
• Generous Paid Time Off
• 401(k) with Generous Employer Match
• Career Growth Opportunities
• Supportive and Collaborative Team Environment

Position Summary

What You'll Do

• Coordinate payer credentialing and recredentialing activities for specialty pharmacies, infusion centers, and affiliated providers
• Prepare, complete, and submit payer enrollment and credentialing applications accurately and within established deadlines
• Manage Medicare and Medicaid enrollment and revalidation submissions
• Maintain organized records of licenses, accreditations, insurance documents, provider credentials, and enrollment documentation
• Serve as the primary point of contact for payer credentialing departments regarding application statuses, delays, and resolution of issues
• Monitor credentialing milestones and maintain accurate records within Salesforce and credentialing databases
• Track application progress and proactively communicate updates to internal stakeholders
• Maintain detailed documentation to satisfy commercial, government, and third-party payer requirements
• Ensure provider information is accurate and consistent across credentialing platforms and payer applications
• Support compliance with regulatory, accreditation, and contractual requirements
• Protect patient privacy and maintain confidentiality in accordance with HIPAA guidelines
• Assist with special projects and additional duties as assigned

Required Qualifications

• Minimum of 3 years of payer credentialing experience
• Experience completing payer credentialing applications through multiple submission methods
• Experience with Medicare and Medicaid payer enrollment processes
• Experience working within home infusion, specialty pharmacy, provider services, or healthcare organizations
• Working knowledge of:
  • CAQH
  • PECOS
  • NPPES
  • NCPDP
• Ability to interpret and utilize provider taxonomy codes, NPIs, and other provider identifiers
• Experience managing multiple applications simultaneously while meeting deadlines
• Strong organizational skills and attention to detail
• Excellent verbal and written communication skills
• Ability to work independently in a remote environment
• Proficiency with Microsoft Outlook, Word, Excel, and SharePoint

Preferred Qualifications

• Medicare and Medicaid enrollment and revalidation experience
• Home Infusion experience
• Specialty Pharmacy experience
• Experience navigating contract management software
• Experience supporting provider and organizational credentialing initiatives across multiple states

How to Apply

About AIS Healthcare

AIS Healthcare | Advancing Quality. Improving Lives.