Provider Enrollment & Credentialing Specialist

Pinnacle Wound Management

  • Miami, Florida
  • 30+ days ago

    Highlights

    At Pinnacle Wound Management, we are dedicated to improving the lives of patients through high-quality wound care delivered by expert physicians, nurse practitioners, and physician assistants. The Provider Enrollment & Credentialing Specialist will be responsible for the full-cycle credentialing and enrollment of our healthcare providers, including physicians and mid-level practitioners.

    Numbers & Facts

    LocationMiami, Florida
    Websitewww.pinnaclewoundmanagement.com

    Description


    Job Title:Provider Enrollment & Credentialing Specialist
    Company: Pinnacle Wound Management
    Location: Gainesville, GA
    Employment Type:Full-Time



    About Us:
    At Pinnacle Wound Management, we are dedicated to improving the lives of patients through high-quality wound care delivered by expert physicians, nurse practitioners, and physician assistants. As a growing leader in this specialized healthcare field, we’re looking for a detail-oriented and proactive Provider Enrollment & Credentialing Specialistto support our expanding clinical team.



    Position Overview:
    The Provider Enrollment & Credentialing Specialist will be responsible for the full-cycle credentialing and enrollment of our healthcare providers, including physicians and mid-level practitioners. This role is vital to ensuring that our clinical staff are enrolled with payers, credentialed with facilities, and compliant with all regulatory and operational standards.


    Key Responsibilities:

    • Manage the credentialing and re-credentialing processes for physicians, nurse practitioners, and physician assistants.

    • Enroll new providers with Medicare, Medicaid, and commercial insurance plans.

    • Maintain accurate and up-to-date provider information in internal databases and with payer systems.

    • Track expirables (e.g., licenses, certifications, malpractice insurance) and ensure timely renewals.

    • Communicate with providers and internal departments to gather necessary documentation and resolve enrollment or credentialing issues.

    • Monitor and respond to payer requests and follow up to ensure timely processing.

    • Stay current on enrollment and credentialing regulations and payer requirements.

    • Support facility privileging processes when applicable.

    Qualifications:

    • 2+ years of experience in healthcare credentialing and/or provider enrollment.

    • Familiarity with CAQH, PECOS, NPPES, and commercial insurance enrollment processes.

    • Strong organizational skills and attention to detail.

    • Ability to work independently and manage multiple tasks and deadlines.

    • Excellent communication skills, both written and verbal.

    • Experience in wound care or with mobile healthcare providers is a plus.

    Preferred Skills:

    • Knowledge of credentialing software and platforms.

    • Experience working with a geographically distributed provider team.

    • Understanding of state licensing requirements and compliance standards.

    Why Join Us?

    • Opportunity to be part of a mission-driven team making a direct impact on patient care.

    • Supportive and collaborative work environment.

    • Competitive salary and benefits package.




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