Top 3 Credentialing specialist Jobs in Albuquerque Nm

Credentialing & Enrollment Specialist
Leoforce —Albuquerque, NM
- $50,000 - $60,000 a year
- Research
- Mid-level
- Organizational skills
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1d
Credentialing Specialist
VTP Holdings —Albuquerque, NM
- $20 - $24 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Mileage reimbursement
- Health insurance
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Credentialing Specialist (Part-Time with Full-Time Growth Opportunity)
Prestige Billing Co. —Albuquerque, NM
- From $22 an hour
- Part-time
- Hybrid work
- Mid-level
- Office
- Organizational skills
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11d

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University of New Mexico —Los Lunas, NM
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Residential Program Manager
Mandy's Farm —Albuquerque, NM
Must have a valid driver’s license, car insurance and reliable transportation. Ensure responsible petty cash management, reconciling petty cash logs monthly,…
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Credentialing & Enrollment Specialist

Leoforce -
Albuquerque, NM

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Job Details

$50,000 - $60,000 a year
1 day ago

Qualifications

Confidential information handling
Expiration dates monitoring
Medicare
Provider database maintenance for medical credentialing
Community health center experience
Provider enrollment for medical credentialing
Filing
Research
Mid-level
Medical administrative support
Compliance documentation
Organizational skills
Healthcare provider information
Medicaid
Productivity software
Non-profit experience
Healthcare software applications
Communication skills
Audit support

Full Job Description

Experience: Mid Level
Salary: $50,000 - $60,000 per year

Job Details
-

The Credentialing & Enrollment Specialist will coordinate provider credentialing, recredentialing, and payer enrollment activities to ensure healthcare providers remain properly credentialed and eligible to provide and bill for services.

This position requires exceptional attention to detail, organization, follow-through, and the ability to manage multiple provider files and deadlines simultaneously.

Responsibilities include:

Coordinate initial credentialing and recredentialing for physicians, advanced practice providers, behavioral health professionals, and other -applicable healthcare providers
Complete and submit provider enrollment applications with Medicare, New Mexico Medicaid, commercial insurance plans, and other third-party payers
Maintain and update provider information within CAQH and other payer or credentialing systems
Track credentialing and enrollment applications from initial submission through approval
Follow up with insurance carriers and other organizations regarding outstanding applications, documentation, and enrollment status
Maintain accurate provider credentialing files and databases
Verify and monitor professional licenses, board certifications, DEA registrations, malpractice coverage, and other required credentials
Track expiration and renewal dates and proactively obtain updated documentation
Assist providers with completing applications, obtaining signatures, and submitting required documentation
Coordinate provider additions, terminations, demographic changes, and other updates with insurance carriers
Support provider onboarding by ensuring credentialing and payer enrollment requirements are completed accurately and efficiently
Work closely with Billing, Human Resources, Compliance, clinic leadership, and providers to resolve credentialing or enrollment issues
Maintain confidentiality of provider and organizational information
Assist with audits and ensure credentialing documentation remains complete, accurate, and compliant
Identify delays or discrepancies that could impact provider enrollment or reimbursement and work proactively toward resolution

What We're Looking For:

Previous experience with healthcare credentialing, provider enrollment, medical staff services, or a closely related healthcare administrative function
Experience with Medicare, Medicaid, and/or commercial payer enrollment strongly preferred
Knowledge of CAQH and electronic provider enrollment systems preferred
Familiarity with New Mexico Medicaid enrollment is highly desirable
Understanding of provider licensing, certifications, DEA registrations, malpractice coverage, and credentialing documentation
Strong organizational skills and exceptional attention to detail
Ability to track multiple providers, applications, deadlines, and renewals simultaneously
Strong written and verbal communication skills
Comfortable communicating directly with healthcare providers, insurance carriers, and internal departments
Strong computer skills, including Microsoft Office and healthcare administrative systems
Ability to independently research issues and follow applications through completion
Experience within a nonprofit, community health center, FQHC, or similar healthcare environment is a plus

A bit about us:
-

Mission-driven nonprofit healthcare organization
Opportunity to directly support access to healthcare in the Albuquerque community
Collaborative environment working with providers, clinical leadership, billing, HR, and administrative teams
Stable organization with an important community mission
Opportunity to take ownership of provider credentialing and enrollment processes
Comprehensive benefits and opportunities for professional growth.

Why join us?
-

Mission-driven nonprofit healthcare organization
Opportunity to directly support access to healthcare in the Albuquerque community
Collaborative environment working with providers, clinical leadership, billing, HR, and administrative teams
Stable organization with an important community mission
Opportunity to take ownership of provider credentialing and enrollment processes
Comprehensive benefits and opportunities for professional growth

#operations #payer-enrollment #provider-credentialing #caqh-medicare-medicaid #tier2

Quick Apply

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credentialing specialist jobs in albuquerque nm

Credentialing & Enrollment Specialist

Credentialing Specialist

Credentialing Specialist (Part-Time with Full-Time Growth Opportunity)

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