Senior Provider Enrollment & Credentialing Specialist

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TYPE OF WORK

Full Time

SALARY

$12 - $18 / hr

HOURS PER WEEK

40

DATE UPDATED

Aug 25, 2026

JOB OVERVIEW

GetPaneled is a U.S. healthcare credentialing company that helps independent providers and healthcare practices enroll with insurance networks.

We are looking for an experienced Provider Enrollment & Credentialing Specialist who can independently manage U.S. healthcare credentialing and payer enrollment processes from start to finish.

This is not a general Virtual Assistant role and is not an entry-level healthcare administration position. Applicants should already have significant hands-on experience personally completing payer enrollment applications and managing credentialing workflows.

You will be responsible for managing provider credentialing applications, determining what information or documents are needed, completing payer applications, following up with insurance companies, resolving issues, and moving applications through to completion.

You should be comfortable working independently and making credentialing-related decisions without needing detailed step-by-step instructions.

Required experience:

Hands-on U.S. healthcare payer credentialing and provider enrollment experience
CAQH profile setup, maintenance, and attestation
NPI Type 1 and NPI Type 2 / NPPES
Individual providers versus group/practice enrollments
EIN/TIN, W-9, practice entity, billing and service-location concepts
Commercial insurance credentialing and enrollment
Experience with major payers such as Aetna, UnitedHealthcare/Optum, Cigna/Evernorth, Blue Cross Blue Shield plans, and similar commercial insurers
Experience submitting and following up on payer applications
Experience with payer portals such as Availity and other insurer-specific portals
Understanding of credentialing, contracting, enrollment, effective dates, and provider loading
Strong written and spoken English
Ability to call U.S. insurance companies and professionally follow up on applications
Strong organization and attention to detail
Ability to independently manage many applications at the same time

Strongly preferred:

Medicare / PECOS experience
Medicaid enrollment experience
Behavioral health provider credentialing, including therapists, psychologists, psychiatrists, NPs, and group practices
Experience with multi-state credentialing
Experience managing or reviewing the work of other credentialing specialists
Medical billing / revenue cycle management experience

Billing experience is a plus because we may expand the role into billing operations over time, but the immediate priority is credentialing and provider enrollment expertise.

This position has significant room for responsibility. A strong candidate may eventually help manage our overall credentialing operations and other credentialing team members.

To apply, please answer these questions in your application:

How many years have you personally worked in U.S. payer credentialing/provider enrollment?
Which commercial insurance companies have you personally completed applications for? Please list them.
Which state Medicaid programs have you worked with?
Have you handled both individual provider and group/practice enrollments?
Describe your experience with CAQH, NPPES, NPI Type 1 and NPI Type 2.
Approximately how many credentialing or enrollment applications have you managed at one time?
Tell us about one difficult credentialing/enrollment issue you personally resolved.
Are you comfortable making phone calls to U.S. insurance companies?
What hourly rate are you requesting?

SKILL REQUIREMENT
Revenue Cycle Management Credentialing HIPAA Compliance
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