Provider Enrollment Specialist II

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🕒 May 26

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Altais

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2019

👥 B2C

🧘 Wellness

B2C • Wellness

Altais is a California-based healthcare provider network that unifies multiple medical brands to offer coordinated primary care, urgent care, specialty services, hospitals and labs, and mental and senior health across Northern and Southern California. The organization supports physicians and care teams with technology-enabled patient portals and value-based care partnerships, serving patients directly while also working with providers and partners to improve access, affordability, and care coordination.

📋 Description

• Independently managing the full lifecycle of provider credentialing, recredentialing, and payer enrollment • Ensuring compliance with AMG policies, health plan delegation requirements, NCQA standards, and government payer rules • Handling moderately complex enrollment issues • Communicating provider changes to contracted health plans and management via standardized reports • Managing Medicare revalidation cycles and submitting updates through PECOS • Performing annual Medi ‑ Cal renewals and maintaining records in PAVE • Collaborating with IT/EHR analysts to correct provider setup and other configuration components required for clean claim submission • Responsible for all aspects of credentialing/recredentialing providers • Performing routine audits to assure accuracy • Maintaining effective communication with health plan representatives and AMG departments

🎯 Requirements

• High school diploma or equivalent • 3–5 years of healthcare credentialing and payer enrollment experience; IPA, physician group, or Revenue Cycle experience preferred • Excellent computer skills, including Microsoft Office (Word, Outlook, Excel, PowerPoint) • Ability to use independent judgment and initiative within established policies and procedures • Strong relationship ‑ building skills across all levels of staff, management, and external payer contacts • Excellent written and verbal communication skills • Exceptional organizational skills and the ability to manage multiple projects concurrently • Ability to obtain, synthesize, and analyze data and recommend solutions • Ability to draft presentations, handouts, and communications • Demonstrates a learning and growth mindset; proactive and solution ‑ oriented. • Certified Provider Credentialing Specialist (CPCS) preferred. • National Association Medical Staff Services (NAMSS) coursework or certification preferred.

🏖️ Benefits

• Excellent medical, vision, and dental coverage • 401k savings plan with a company match • Flexible time off and 9 Paid Holidays