Provider Enrollment & Credentialing Specialist

Pinnacle Wound Management

Miami, FL

JOB DETAILS
LOCATION
Miami, FL
POSTED
21 days ago


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.




About the Company

P

Pinnacle Wound Management