Medical Credentialing & Payer Enrollment Specialist | CAQH, PECOS & Commercial Networks

I am a dedicated Medical Credentialing and Payer Enrollment Specialist experienced in helping solo providers, behavioral health professionals, group practices, and multi-provider clinics navigate the complete credentialing and enrollment process.

I manage the workflow from initial application through final approval and effective date, helping ensure providers are properly credentialed, contracted, linked to their group, and ready for clean claims submission.

Core Expertise & Services:

Initial credentialing and periodic re-credentialing

CAQH ProView management and quarterly attestations

NPPES updates, PECOS/Medicare, and State Medicaid enrollment

Commercial payer applications & major network onboarding

Group and individual NPI enrollment & TIN/W-9 linkage

Roster submissions, demographic updates, and ongoing maintenance

Payer Network Experience:
Experienced across major commercial and government health plans, including Aetna, Anthem/BCBS, Carelon, Humana, Molina, UnitedHealthcare/Optum, Medicare, and Medicaid.

Why Work With Me:
What sets my work apart is consistent follow-up and rigorous attention to detail. I actively monitor applications, communicate with payer credentialing and provider relations desks, resolve enrollment hurdles, document reference numbers, and follow each case through to completion.

Work Terms

Availability: Monday through Friday, with flexible hours for urgent application monitoring and follow-ups.

Communication: Clear, prompt updates via platform messages regarding application milestones and reference numbers.

Project Terms: Flat fee per payer/task or milestone-based structures tailored to individual project scope and ongoing maintenance needs.