Credentialing and Payer Enrollment Representative

PLEASE DO NOT APPLY IF YOU DO NOT HAVE RELEVANT EXPERIENCE:

Contracting, Credentialing and Payer Enrollment Representative

Peregrine Healthcare is seeking a detail‑oriented, self‑driven Contracting & Credentialing Representative to support our provider clients with timely, accurate, and professional contracting and credentialing services. This role requires strong communication skills, excellent documentation habits, and the ability to manage multiple tasks in a fast‑paced environment.

Key Responsibilities:

Contracting:

Coordinate with provider offices and health plan representatives to complete contracting tasks efficiently.

Conduct professional telephone and email follow‑ups with insurance carriers and clients.

Upload executed agreements to ShareFile and maintain organized records.

Perform periodic EOB reviews for retainer clients.

Credentialing:

Manage credentialing workflows and communicate with provider offices and health plans.

Maintain thorough documentation throughout all credentialing processes.

Provide 30‑day advance notice for expiring documents and obtain updated materials.

Update CAQH and facility documentation as needed.

Complete and track facility and insurance applications through to approval.

Follow up on outstanding items at appropriate intervals.

Administrative & Communication Duties:

Complete weekly, monthly, quarterly, and annual checklist tasks within required timeframes.

Answer and route phone calls as needed.

Respond to client email s promptly and maintain timely interoffice communication.

Check email periodically throughout the day to ensure responsiveness.

Additional Responsibilities:

Assist management with assigned tasks.

Lead or participate in client conference calls to review active items and address concerns.

Communicate any issues or client concerns to the Manager.

Enter notes into systems concurrently with work performed.

Suggest productivity improvements and adhere to internal workflow timeframes.

Team Expectations:

Participate in team meetings, training sessions, and onboarding of new staff.

Maintain a positive, professional attitude and uphold all requirements in the Peregrine Contractor Handbook.

Notify management immediately of any errors or issues.

Qualifications:

Strong English communication skills (written and verbal).

High attention to detail and strong organizational habits.

Ability to manage multiple priorities and meet deadlines.

Professional demeanor and customer‑service mindset.

Experience in contracting, credentialing, or payer enrollment mandatory.