Credentialing & Enrollment Specialist

Responsibilities

• Complete and track credentialing and payer enrollment applications for all Imagen providers on behalf of customers across commercial, Medicare, and Medicaid plans.
• Partner directly with customers to research their specific payer mix and requirements, ensuring enrollment applications are tailored to their unique timelines and processes.
• Proactively analyze provider documentation and professional history against customer requirements, ensuring application completeness and readiness.
• Establish, refine, and document processes for gathering payer and provider information to enable efficient, accurate, and timely enrollments.
• Input, update, and maintain internal databases and CAQH profiles for Imagen providers to ensure data readiness.
• Communicate regularly with providers, customers, and internal teams to troubleshoot issues, resolve application delays, and ensure seamless credentialing and enrollment.
• Provide regular updates to internal stakeholders regarding enrollment progress, risks, and overall project timelines.
• Support audits and compliance reviews by ensuring documentation and records are accurate, up to date, and easily accessible.

Qualifications

• An associate’s degree and/or bachelor’s degree.
• 3+ years of payer enrollment/credentialing experience; experience within a radiology department or practice is a strong plus.
• Direct experience managing CAQH profiles and utilizing credentialing and enrollment platforms; experience with CredflowAI is a strong plus.
• Experience working with radiologists and/or other specialists across diverse healthcare environments, e.g. health systems, hospitals, outpatient clinics, etc.
• Highly organized and proactive self-starter with strong attention to detail and effective communication skills.
• Certified Provider Enrollment Specialist (CPES) and/or Certified Provider Credentialing Specialist (CPCS) certification highly preferred.

Compensation & Benefits

• The hourly rate for the position is between $31.25 - $35.00, plus benefits.