Top 8 Credentialing specialist remote Jobs in Mcdonough Ga

Payor Enrollment Specialist
Aylo Health —Atlanta, GA
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
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7d
Medical Licensing Specialist
Core Clinical Partners —Atlanta, GA
- Remote
- Customer service
- Mid-level
- High school diploma or GED
Quick Apply
3d
ABA Billing Specialist
Atlanta Autism Center —Atlanta, GA
- $50,000 - $60,000 a year
- Management
- Medical office experience
- HIPAA
Quick Apply
Medical Staff Liaison- Anesthesia Services
SCP Health —Atlanta, GA
- $20 - $28 an hour
- Full-time
- Medical office experience
- Mid-level
- Office
- Paid holidays
- Health insurance
2d
Assistant Director of Special Education Compliance
Georgia Cyber Academy —Atlanta, GA
- Full-time
- Hybrid work
- Doctoral degree
- Office
- 3 years
Inpatient Coding Auditor
Huron Managed Services LLC —Atlanta, GA
- $38.46 - $52.40 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Dental insurance
Quick Apply
11d

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credentialing specialist remote jobs near mcdonough ga

Payor Enrollment Specialist

Aylo Health -
Atlanta, GA

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Job Details

Full-time
7 days ago

Qualifications

Microsoft Excel
Microsoft Outlook
Medicare
Phone communication
Provider enrollment for medical credentialing
High school diploma or GED
Health insurance knowledge
Medicare regulations
Centers for Medicare and Medicaid Services (CMS)
Microsoft Teams
Medicaid regulations
Medicaid

Full Job Description

At Aylo Health, we work together to enrich the health and well-being of every life we touch. Our mission is to make quality healthcare simple and convenient. Because healthy people can do amazing things!

We offer a work environment that values the creation of lifelong relationships, while also providing opportunities for growth and career development. We strive to care for each other with the same passion with which we care for our patients. Aylo Health offers competitive pay to team members who provide high-quality care, while delivering an exceptional patient experience.

Position Summary

The Payor Enrollment Specialist is responsible for coordinating and managing the enrollment, revalidation, maintenance, and termination of providers and facilities with commercial and government payors. This position ensures providers are enrolled accurately and in a timely to support uninterrupted reimbursement and compliance with regulatory and contractual requirements.

The specialist works closely with providers, practice operations, credentialing staff, payors, and revenue cycle teams to monitor enrollment status, resolve issues, and maintain accurate provider data across all systems.

Location: Remote in Georgia; Occasional in office meetings in Marietta, GA.

Schedule: Full time Monday- Friday 8:00AM - 5:00PM

Key Responsibilities

Payor Enrollment Management

Prepare, complete, and submit provider and facility enrollment applications to commercial, Medicare, Medicaid, and managed care payors.

Manage new enrollments, revalidations, group affiliations, roster additions, demographic updates, and terminations.

Monitor application status and proactively follow up with payors to ensure timely processing.

Research and resolve enrollment delays, denials, and participation issues.

Maintain detailed documentation of all enrollment activities and communications.

Provider and Facility Data Maintenance

Ensure provider demographic information remains accurate across enrollment platforms and internal databases.

Submit updates related to provider locations, tax IDs, NPIs, licensure, ownership changes, and other required information.

Maintain provider records in credentialing and enrollment management systems.

Perform regular audits to verify data integrity and compliance.

Collaboration and Communication

Serve as a liaison between providers, practice leadership, credentialing teams, revenue cycle departments, and payors.

Provide timely updates regarding enrollment status and expected effective participation dates.

Assist with resolving network participation and reimbursement-related enrollment concerns.

Respond to provider and stakeholder inquiries regarding enrollment requirements and processes.

Compliance and Quality Assurance

Ensure enrollment activities comply with federal, state, accreditation, and payor requirements.

Maintain knowledge of Medicare, Medicaid, and commercial payor enrollment guidelines.

Support internal and external audits related to provider enrollment documentation.

Adhere to organizational policies, procedures, and confidentiality requirements.

Reporting and Performance Monitoring

Track enrollment metrics and maintain enrollment status reports.

Identify enrollment trends, bottlenecks, and opportunities for process improvement.

Assist leadership with reporting related to provider onboarding and enrollment performance.

Required Qualifications

Education

High School Diploma or GED required.

Associate's or bachelor's degree in healthcare administration, Business Administration, or related field preferred.

Experience

Minimum 2 years of experience in provider enrollment, credentialing, revenue cycle, or healthcare administration.

Experience working with commercial, Medicare, and Medicaid payor enrollment processes.

Experience using credentialing and enrollment software platforms preferred.

Knowledge, Skills, and Abilities

Knowledge of provider enrollment and credentialing principles and practices.

Familiarity with Medicare PECOS, NPPES, CAQH ProView, and state Medicaid enrollment systems.

Strong understanding of healthcare reimbursement and payor requirements.

Excellent organizational and time management skills.

Strong attention to detail and accuracy.

Effective written and verbal communication skills.

Ability to manage multiple priorities and deadlines in a fast-paced environment.

Proficiency with Microsoft Office Suite, including Excel, Word, Outlook, and Teams.

Preferred Qualifications

Certified Provider Credentialing Specialist (CPCS) designation or willingness to obtain certification.

Experience in a multi-specialty physician group, hospital system, or managed services organization.

Knowledge of provider onboarding and credentialing workflows.

Physical Requirements

Prolonged periods of sitting and computer use.

Ability to communicate effectively via phone, video conference, and email.

Occasional lifting of up to 15 pounds.

Success Metrics

Timely submission of enrollment applications.

Reduction in enrollment processing delays.

Accuracy of provider data and enrollment records.

Successful completion of revalidations and demographic updates.

Provider onboarding completed within established organizational timelines.

Maintenance of compliance with regulatory and payor requirements.

Equal Employment Opportunity Statement: The organization is committed to providing equal employment opportunities to all employees and applicants and prohibits discrimination and harassment of any type

Aylo Health is an Equal Opportunity Employer

Quick Apply

Refine Your Search

credentialing specialist remote jobs in mcdonough ga

Payor Enrollment Specialist

Medical Licensing Specialist

ABA Billing Specialist

Medical Staff Liaison- Anesthesia Services

Assistant Director of Special Education Compliance

Inpatient Coding Auditor

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