Credentialing Administrator, Healthcare Payer Operations
Overview
Own payer enrollment and credentialing mgmt for physicians and providers across Arizona practices. You will collaborate with a Credentialing team and interact with providers, health plans, and internal stakeholders to resolve enrollment issues. The role emphasizes research, attention to detail, and independent problem solving in a healthcare payer environment. This position starts onsite in Scottsdale with potential for remote work after training and transition.
What You'll Do9
- 1Build and maintain credentialing records for new and existing providers
- 2Manage provider enrollment, terminations, and demographic updates with health plans
- 3Verify licensure, board certification, DEA, education, and other credentials
- 4Navigate payer portals and credentialing systems to submit applications and monitor status
- 5Research discrepancies and payer requirements to drive timely resolution
- 6Maintain provider data in CAQH and other platforms
- 7Escalate issues and build relationships with payer and provider representatives
- 8Monitor renewal and recredentialing timelines and outstanding payer requests
- 9Support EFT and ERA enrollment or related payer functions as assigned
Requirements6
- 1Experience in payer contracting, provider relations, or healthcare revenue cycle functions
- 2Understanding of commercial, Medicare, and Medicaid enrollment processes
- 3Familiarity with CAQH or similar credentialing systems
- 4Strong organizational skills and ability to manage multiple providers and deadlines
- 5Comfort working onsite with potential for remote transition
- 6Ability to research payer requirements and resolve complex enrollment issues
Salary Insight
Salary not disclosed in listing
Location
Required Skills
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