Credentialing and Enrollment Specialist I at Relias Healthcare

Job Purpose

The Credentialing & Enrollment Specialist I supports the accurate and timely credentialing and payer enrollment of all Relias Healthcare providers. This role ensures insurance participation is secured before or in alignment with provider start dates to minimize reimbursement delays and support seamless patient care. The Specialist is essential to maintaining organized, complete provider records and facilitating collaboration across internal teams and external payer contacts. This position contributes directly to the success of our revenue cycle and our mission to empower clinicians and healthcare partners through reliable, high-quality solutions.

Duties and Responsibilities 

Understanding that providers are Relias’ number one priority and greatest asset, the Credentialing & Enrollment Specialist I plays a key role in ensuring providers are fully credentialed and enrolled with payers in a timely and accurate manner. Your responsibilities include maintaining and updating CAQH and Modio profiles, submitting enrollment applications, tracking statuses, managing license renewals, and verifying data for accuracy, completeness, and compliance. You will serve as a subject-matter expert for providers, working closely with internal teams, medical staff offices, billing vendors, and partner sites to prioritize onboarding and minimize delays. This role requires strong attention to detail, proactive problem-solving, and the ability to thrive in a high-volume, fast-paced environment. Your work directly supports provider readiness, financial operations, and the delivery of high-quality patient care by removing administrative barriers.

Qualifications

• High school diploma or equivalent required; associate’s or bachelor’s degree preferred.
• Minimum of two years of experience in a healthcare or medical business office.
• Demonstrated knowledge of credentialing and payer enrollment processes.
• Experience working with payer enrollment systems and portals.
• Intermediate proficiency in Microsoft Excel.
• Strong attention to detail and independent problem-solving ability.
• Ability to prioritize and meet ongoing deadlines.
• Excellent verbal and written communication skills.

Working Location

Remote position with periodic travel to the corporate office (approximately quarterly or as requested by leadership).

Direct Reports

• N/A

Benefits

• Health, Dental, Vision, Life, and Disability insurance

• Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA)

• Employee Assistance Program (EAP)

• 401(k) and matching
• Paid Time Off