About the Role:
At Alico, we know that revenue predictability starts before a patient is ever seen. Credentialing delays and misaligned payer contracts are massive drivers of downstream denials. While our technology tracks expiration dates and handles routine document routing, we rely on our Credentialing & Contracting Specialists to manage complex payer matrices, resolve enrollment bottlenecks, and ensure every provider is fully cleared to generate clean, payable claims.
What You Will Do:
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Drive the end-to-end credentialing and re-credentialing process for commercial payers, Medicare (PECOS), and Medicaid.
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Maintain strict accuracy of CAQH profiles and provider rosters to prevent "provider not enrolled" claim edits.
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Track payer contract structures, fee schedules, and linked facility locations to support accurate expected-versus-paid variance reporting.
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Actively manage escalation paths for stalled payer enrollments, directly contacting payer representatives to resolve application exceptions.
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Audit and update internal systems to ensure billing teams have real-time visibility into effective dates and network participation status.
Who We Are Looking For:
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3+ years of enterprise experience in healthcare credentialing, provider enrollment, or payer contracting for multi-specialty groups or facilities.
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Deep fluency with CAQH, PECOS, and navigating complex commercial payer enrollment portals.
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A highly disciplined operator who understands that clean credentialing data is the foundation of a 98%+ first-pass clean claim rate.
Location: Remote (Strictly limited to MA, FL, CT, PA, Montreal or NC residents)
Schedule: Part-Time (25 hours/week)