Credentialing and Payer Enrollment Specialist

We are seeking a highly organized and detail-oriented Credentialing & Payer Enrollment Specialist to join our team. The successful candidate will be accountable for data collection, organization and submission of applications required by health plans, hospitals and governmental and other regulatory agencies.You Will:Maintain Credentialing and Payer Enrollment of Incyte Diagnostics’ PathologistsSuccessfully oversees the entire payer enrollment process through Pathologist’s onboarding (start date) and off boarding (exit date) (physician life cycle with Incyte)Maintains timelines enrollment schedules, communicates with Pathologist and other departments to update as needed, clarifies information requirements with internal and external stakeholders, and maintains strict level of confidentiality to provider information.Oversees the collection, tracking, verification, and maintenance of all pathologists’ information needed for enrollment, provider demographic updates, Incyte Diagnostics’ demographic updates, and payer contracting requirements. Payer Enrollment data includes but not limited to Medicare, Medicaid, private/commercial, and worker’s compensation payers electronic or paper enrollment and re-enrollment applications; licensure, certifications, and hospital affiliations; peer references & work history; practiceProvide Administrative Support & Human Resources SupportProvides back-up for production and interpretation of pathologists' schedules, complying with corporate guidelines regarding time off, staffing, etc.; is able to determine staffing needs to resolve staffing issues, etc.Assist with travel needs for current and interviewing pathologists.Assist with new pathologist Onboarding to include communication with pathologist(s), scheduling onboarding meetings with staff and coordinating hospital orientations.Management of small hospital lab visit to include scheduling and production/distribution of reports of visit.Verify and maintain accurate provider information in compliance with industry regulationsSuccessfully oversees the entire hospital credentialing process through Pathologist’s onboarding (start date) and offboarding (exit date) (physician life cycle with Incyte)Maintains timelines credentialing schedules, communicates with Pathologist and other departments to update as needed, clarifies information requirements with internal and external stakeholders, and maintains strict level of confidentiality to provider information.Collaborate with medical professionals to ensure that all medical claims are processed accurately and efficientlyMaintain up-to-date knowledge of industry regulations and requirementsCommunicate with healthcare providers to obtain necessary information and documentationEducation / Skills:Minimum QualificationsAssociate Degree or high school diploma equivalentA minimum of two years’ experience in provider credentialing, payer enrollment, healthcare, or general office experienceMust be highly organized, motivated self-starter with impeccable attention to detail.Must work with a sense of urgency and demonstrate the ability to prioritize and work effectively under pressure.Possess excellent communication skills (written, presentation, listening, and oral)Proven ability to interact with physicians and support staff.Evidence of ability to coordinate multiple projects and tasks of medium complexity. Advanced proficiency in Microsoft Office programsPreferred QualificationsBachelor’s Degree in Health Care Administration or equivalentCertified Provider Credentialing Specialist (CPCS) OR meet requirements to become certified within 6 months of hire.Working knowledge of Joint Commission Standards, NCQA Standards, FCVS, obtaining medical licensures, CAQH, OneHealthPort, PECOS (Medicare), AMA, PECOS and primary data source verifications.Familiarity with electronic medical records systems.Pay Range: $21.21 - $29.70 USD Hourly Annual The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Generally, new hire offers will be between the minimum and midpoint of the salary range, depending on experience (DOE), with the ability to grow within the range over time.Incyte Diagnostics is EOE: All qualified applicants will receive consideration for employment without regard to race, color, disability or protected veteran status.

Created: 2025-06-14