Provider Credentialing & Enrollment Specialist

📋 Description

• • This part-time, temporary remote position supports provider enrollment, revalidation, and maintenance across multiple payors and states, with potential to transition into a full-time role at PM Pediatrics Management Group, LLC.
• • Day-to-day responsibilities include reviewing and resolving enrollment issues with focus on state-specific requirements, identifying and trending denial patterns (e.g., taxonomy mismatches, missing DEA, non-participating providers), reviewing Medicaid applications and revalidations at group and individual levels, supporting NY ETIN and ETINS processing, preparing and submitting monthly rosters, managing delegated rosters via Medallion platform, tracking and resolving payor pending items over 90 days, managing email correspondence, supporting telehealth enrollment workflows, assisting with administrative tasks and audit readiness, ensuring timely and accurate Medallion vendor submissions, and collaborating with leadership to identify root causes of delays.
• • The role operates within a mission-driven organization committed to bringing passion and customer focus to pediatric healthcare services, where employees believe in the impact of their work on patient access and reimbursement.
• • The specialist will develop expertise in multi-state provider credentialing, Medicaid revalidation processes, payor compliance, and healthcare administrative systems, gaining experience in process improvement, denial prevention, and cross-functional collaboration that supports timely provider participation and revenue cycle integrity.