Credentialing & Enrollment Coordinator

What you'll do

• Prepare, submit, and track laboratory enrollments and revalidations with Medicare (CMS-855B via PECOS), state Medicaid programs, Medicare Advantage, and commercial payers.
• Manage EDI claim enrollments (837) and ERA (835) and EFT enrollments with payers and clearinghouses, coordinating testing and go-live with the billing system vendor.
• Perform XiFin file maintenance, including payer, provider, NPI, and ordering-physician setup, so claims route and remittances post correctly.
• Maintain the lab’s credentialing data and documents, including NPPES, CAQH, CLIA and CAP certificates, state lab licenses, and W-9s, and track expiration and revalidation dates.
• Keep a credentialing and enrollment tracker current with application status, effective dates, payer IDs, and follow-up actions.
• Follow up with payers on pending applications and resolve enrollment-related denials, holds, and rejections with the billing team.