Credentialing and Enrollment Coordinator

Job not on LinkedIn

🔥 0 minutes ago

🌐 Mexico, Colombia, +1 more countries – Remote

🇲🇽 Mexico – Remote 🇨🇴 Colombia – Remote 🇵🇪 Peru – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

✨ Credentialing Coordinator

👻 Ghost score 22%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Combine | Global Recruitment

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2021

🎯 Recruiter

🤝 B2B

Recruitment • B2B

Combine | Global Recruitment is a Latin America-focused recruitment and staffing firm that helps companies build high-performing teams with pre-vetted LATAM professionals. They offer Outsourcing (handling vetting, compliance and payroll), Direct Hire (full talent acquisition and integration as direct employees), and Executive Search for C-suite and senior management roles. Their website emphasizes precision, compliance, and impact, and notes that over 200 companies use their Latin America recruitment solutions.

📋 Description

• Own the end-to-end credentialing, re-credentialing, and payer enrollment cycle for licensed healthcare providers • Clear the backlog of lapsed provider applications to protect billing • Run enrollment, revalidation, and maintenance in PECOS, NPPES, CAQH ProView, OPRA/eMedNY, OMH, and OASAS systems • Maintain provider files and licensure records to evidence provider validity at the time of service • Perform primary source verification of state licenses, DEA certificates, malpractice coverage, and education history • Work directly with clinicians to obtain paperwork and maintain active licenses • Partner with HR, Talent Acquisition, and Program Directors to credential new hires during onboarding • Investigate and audit enrollment-related claim rejections with the billing team • Correct data in clearinghouses and state payer registries • Maintain credentialing databases and build and present Tableau dashboards on pipeline, expiration timelines, and application aging • Use Claude and Microsoft Copilot to summarize regulations, draft compliance correspondence, and automate administrative work • Take on additional projects assigned by the Senior Director

🎯 Requirements

• Advanced end-to-end credentialing and enrollment experience in US healthcare, with 3–5 years of experience • English proficiency at C1/C2 level; B2 accepted for an otherwise exceptional candidate • Hands-on experience with PECOS, NPPES, CAQH ProView, and Medicare and Medicaid enrollment • CPCS or CPMSM certification • Familiarity with the New York State environment, including OPRA/eMedNY, OMH, OASAS, and NYSED is a strong differentiator • Experience with Tableau dashboards and generative AI tools such as Claude and Microsoft Copilot; openness to these tools is mandatory • Ability to run the credentialing desk independently and raise questions early • Ability to follow up persistently with clinicians to obtain paperwork • Ability to learn an unfamiliar regulatory environment quickly and take on work beyond the job description

🏖️ Benefits

• Fully remote work arrangement • Meaningful impact in a mission-driven nonprofit • Opportunity to work with pre-vetted LATAM professionals and international healthcare operations • Use of generative AI tools, including Claude and Microsoft Copilot