Local Infusion, founded in 2022 and headquartered in Nashville, Tennessee, is a private healthcare company specializing in community-based therapy for patients with chronic conditi
Enrollment & Credentialing Specialist
Location
United States
Posted
41 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Enrollment & Credentialing Specialist
Local Infusion
Role Description The Enrollment & Credentialing Specialist is responsible for enrolling healthcare providers with insurance payers, maintaining accurate credentialing records, and ensuring timely processing of applications, revalidations, and updates across multiple payer platforms. This role supports Contracting, Revenue Cycle, and Operations by ensuring payers are properly enrolled and credentialed to bill without delays and maximize revenue for Local Infusion. - Manage end-to-end payer enrollment for infusion therapy providers with commercial and government payers (Medicare, Medicaid, commercial plans) - Prepare and submit enrollment applications via payer portals (UHC, BCBS, Aetna, Cigna, etc.) and enrollment systems (CMS, Availity, NaviNet, CAQH) - Track application status across multiple platforms, follow up with payers, and resolve issues or discrepancies - Coordinate re-credentialing and revalidation processes to prevent lapses in provider credentials - Communicate regularly with credentialing, contracting, revenue cycle, and payer representatives - Maintain thorough knowledge of payer enrollment processes, credentialing requirements, and RCM processes across different portals and platforms - Ensure compliance with payer requirements, regulations, and organizational policies - Maintain documentation and audit-ready records of all enrollment activities - Manage multiple applications and deadlines simultaneously Qualifications - Bachelor's degree preferred + 1–3 years of experience in payer enrollment, credentialing, healthcare administration, or related revenue cycle function - Familiarity with payer portals (UHC, BCBS, Aetna, Cigna, etc.) and enrollment systems (CMS, Availity, NaviNet, CAQH, etc.) - Thorough understanding of payer enrollment processes, credentialing processes, and RCM processes across multiple different portals and platforms - Strong attention to detail and organizational skills - Ability to manage multiple applications and deadlines simultaneously - Excellent communication and follow-up skills Requirements - Knowledge of revenue cycle management and insurance billing processes - Experience working with multiple payer types (commercial, Medicare, Medicaid) - Problem-solving skills to address enrollment delays or denials - Proficiency in Microsoft Office and credentialing software - Experience in infusion therapy or specialty healthcare billing Benefits - Medical, dental, and vision insurance through our employer plan - Short and long-term disability coverage - 401(k) — as an early-stage startup, and we match! - 15 Days PTO — and we want you to take it! - Competitive paid parental leave and flexible return to work policy - Access to a number of professional development opportunities
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