PerceptGo
We are seeking a part-time highly organized and detail-oriented Provider Enrollment / Credentialing Specialist with strong knowledge of US healthcare payer enrollment processes. The ideal candidate will manage full-cycle credentialing and enrollment for healthcare providers, ensuring timely and accurate submission of applications, payer contracts, updates, and renewals. This role requires excellent communication, follow-up skills, and the ability to work independently while maintaining high-quality standards. Key Responsibilities Full-Cycle Enrollment \& Credentialing Collect, verify, and validate all required provider documentation (licenses, NPI, CAQH, malpractice, W-9, board certifications, resumes, etc.). Prepare, complete, and submit provider enrollment applications to Medicare, Medicaid, and commercial payers. Maintain and update CAQH profiles , ensuring all data is current and re-attested. Complete recredentialing and demographic updates (address changes, TIN updates, specialty updates, group linkage, etc.). Ensure providers are linked to the correct billing groups , facility locations , and taxonomies as required by the payer. Follow-Up \& Compliance Track and manage all submitted applications through approval, rejections, or requests for additional information. Follow up with payers for application status , missing details, or delays. Respond to payer requests, clarifications, and RFI (Requests for Information). Review and obtain contract agreements , ensure provider signatures, and maintain organized contract records. Ensure all enrollments meet payer-specific compliance rules (Medicare PECOS, Medicaid portals, commercial payer portals). Communication \& Coordination Work closely with providers, internal teams, and payer representatives to expedite enrollment. Communicate expected turnaround times, missing documents, and anticipated Go-Live dates. Notify management of any risks, delays, or payer issues impacting credentialing timelines. Recordkeeping \& Reporting Maintain up-to-date tracking sheets and dashboards for every provider and every payer. Document status, timelines, and next steps for all ongoing enrollment projects. Provide weekly reports on pending and completed enrollments. Required Skills \& Qualifications: 3\+ years of experience in US healthcare credentialing or provider enrollment. Strong knowledge of Medicare, Medicaid, and commercial payer enrollment processes . Familiarity with PECOS, CAQH, Availity, NPPES , and specific payer portals. Experience with credentialing for physicians, NPs, PAs, behavioral health, or multiple specialties. Ability to understand provider contracts and payer participation agreements. Strong organizational skills and attention to detail. Excellent communication and follow-up skills. Ability to work independently and manage multiple provider applications simultaneously. Proficiency in Excel/Google Sheets and documentation management. Preferred Qualifications Experience working with RCM companies, MSOs, or medical groups . Knowledge of facility enrollment , group contracts , and delegated credentialing . Familiarity with payer data validation, taxonomy requirements, and TIN/NPI linking . Understanding of credentialing compliance standards (NCQA, URAC, HIPAA). Work Arrangement \& Availability: Contract or part-time availability depending on business needs. Must be able to attend scheduled check-in meetings or calls as required. Ability to prioritize multiple tasks in a deadline-driven environment. Pay: Php8,000\.00 - Php15,000\.00 per month Benefits Work from home Application Question(s): How many years of experience do you have with Provider Enrollment? What type of provider or group specialty have you worked in in your previous projects? What is your expected compensation for this job? Please summarize what CAQH and PECOS are used for. Do you have thorough knowledge of filing Medicare and Medicaid applications? Which commercial plans do you have experience with doing applications in NY and NJ state? Have you worked on the payer side or the provider side? Which state rules are you familiar with or have experience with the Enrollment applications? Location: Philippines (Required) Work Location: Remote
PerceptGo
