Credentialing Enrollment Specialist (Charlotte, NC)

The Mom Project is excited to support our customer, a nationally recognized hospital and healthcare system, with their search for a Credentialing Enrollment Specialist to join their team.

This role is on-site in Charlotte, NC.

Responsibilities:

• Oversee internal processes and regulatory requirements for provider credentialing and enrollment
• Perform primary source verification for credentialing and re-credentialing of providers
• Enter and maintain accurate provider data in internal systems
• Track and follow up on required documentation including licenses, certifications, insurance, and DEA registrations
• Resolve billing-related issues tied to provider enrollment and credentialing
• Prepare provider files for audits by managed care organizations, compliance, and accreditation entities
• Conduct practice site visits and support communication with managed care organizations
• Review provider directories for accuracy of demographic and participation data
• Support credentialing and quality review committees
• Maintain accurate documentation and ensure timely processing of applications
• Collaborate with internal teams to ensure smooth workflow and compliance

Skills and Qualifications:

• High school diploma or GED required; Bachelor’s degree preferred
• Minimum 3 years of experience in provider credentialing, privileging, or enrollment within healthcare or managed care environments
• Strong knowledge of credentialing processes and compliance requirements
• Proficiency in Microsoft Office, especially Word and Excel
• Strong organizational skills and attention to detail
• Ability to manage multiple tasks and deadlines
• Strong problem-solving and issue resolution skills
• Strong communication skills and ability to work with cross-functional teams
• Ability to work independently and be self-driven
• Quick learner with resourceful mindset
• Familiarity with standard office equipment and systems

Preferred Qualifications:

• Certification such as CPCS (Certified Provider Credentialing Specialist) or CPMSM
• Experience working with credentialing databases or healthcare systems
• Experience supporting audits and compliance reviews

We offer a competitive salary range for this position. Most candidates who join our team are hired at the median of this range, ensuring fair and equitable compensation based on experience and qualifications.