Credentialing and Enrollments Specialist

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🔥 38 minutes ago

🌵 Arizona, California, +3 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🌶️ New Mexico – Remote 🌴 South Carolina – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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MODENA

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

👥 B2C

Healthcare • B2C

Modena is a regional healthcare provider focused on allergy, immunology and respiratory care. With multiple clinic locations across Southern California and Arizona, Modena Health offers diagnostic testing and specialized treatments for allergies, asthma, chronic sinusitis, nasal polyps, inflammatory/eosinophilic diseases, immune disorders and pediatric pulmonology. Services highlighted include oral immunotherapy (OIT), sublingual OIT, low-dose immunotherapy, allergy testing, blood testing, and ongoing patient support. The organization is led by founder Brian Modena, MD, MSc, and staffed by board-certified allergists/immunologists, pediatric specialists and respiratory clinicians; the practice also mentions involvement in clinical research and applications of AI, genetics and the microbiome to personalize care.

📋 Description

• The Credentialing & Enrollments Specialist is responsible for managing the credentialing, payer enrollment, and provider onboarding processes for the practice’s physicians and advanced practice providers. • This role ensures providers are credentialed, enrolled, and maintained with commercial and government payers in a timely and accurate manner to support uninterrupted billing and patient care operations. • The specialist maintains provider records, monitors credentialing deadlines, coordinates with payers and providers, and serves as a key resource for credentialing and insurance operations. • This position requires strong organizational skills, attention to detail, and the ability to manage multiple deadlines in a fast-paced healthcare environment. • This role is non-exempt (hourly) and full-time, 40 hours per week, Monday through Friday. Occasional overtime may be required to meet credentialing deadlines or business needs.

🎯 Requirements

• High school diploma or equivalent required. • Associate degree or higher preferred. • Minimum of 2 years of experience in provider credentialing, payer enrollment, medical staff services, or healthcare administration required. • Experience with commercial and government payer enrollment processes strongly preferred. • Working knowledge of CAQH, PECOS, NPPES, and payer enrollment portals required. • Experience maintaining provider records and credentialing databases, including CredentialStream or similar credentialing software. • Experience with hospital privileging and provider onboarding preferred. • Prior experience in allergy, asthma, or specialty medical practices is a plus. • Strong attention to detail and organizational skills. • Excellent written and verbal communication skills. • Ability to prioritize tasks and manage multiple deadlines effectively. • Ability to work independently and collaboratively in a remote environment. • Proficiency in Microsoft Office Suite, EHR systems, practice management software, and online credentialing portals. • Strong problem-solving and follow-up skills.

🏖️ Benefits

• Competitive salary and benefits package, including medical, dental & vision insurance, 401(k) retirement plan with employer matching, and professional development opportunities • In addition, we offer paid time Off (PTO), sick time, floating holiday and holiday pay • Opportunity to shape the future of a thriving allergy and asthma practice in beautiful San Diego (and across our expanding network) • A supportive, mission-focused culture where your contributions directly impact patient outcomes and team growth