Provider Enrollment Specialist

About the role

Are you driven to build the systems that keep healthcare running seamlessly? As a Credentialing Specialist, you'll be part of our credentialing/provider enrollment team to ensure providers are credentialed and enrolled quickly and accurately with health plans and hospitals - so patients always have uninterrupted access to care. Credentialing/enrollment activities on this team include: Filling out provider enrollment applications with health plans, Medicare, Medicaid and hospitals. Following up with health plans and hospitals on submitted applications. Solve complicated credentialing-related issues directly with IPAs and health plans. Maintaining a clean database of provider data and enrollment-related activities in MD Staff. Applying for license renewals. Communicating with providers on credentialing-related updates. This is a hands-on role where you will work with the Credentialing Supervisor and fellow Credentialing Coordinators to ensure all work is completed in a timely and accurate fashion. If you're energized by improving processes and building a credentialing function that supports high-quality care, we'd love to meet you!

Responsibilities

• Work amongst a team of credentialing/enrollment specialists to deliver accurate, timely, and compliant work - including completing credentialing/enrollment tasks.
• Process credentialing, re-credentialing, and privileging applications to keep providers active and patient care uninterrupted.
• Solve enrollment-related issues as they arise, working directly with health plans to get them resolved.
• Monitor application timelines to prevent delays and resolve escalated issues from staff, clinics, and providers.
• Maintain high data quality, including both provider data as well as credentialing data, like expiration dates, contact information, etc.
• Follow SOPs and policies that are designed to streamline workflows and strengthen compliance.
• Maintain compliance with the state, federal, and payer-specific credentialing requirements.
• Act as a liaison for external partners, including payers, hospitals, and credentialing verification organizations.

Requirements

• Bachelor's degree in healthcare administration, business, or related field (preferred).
• 3+ years of experience in provider credentialing.
• Strong knowledge of NCQA standards, payer requirements, and credentialing best practices.
• Excellent problem-solving and critical thinking skills, with the ability to resolve escalated issues.
• Exceptional organization skills, with sharp attention to detail and ability to manage multiple priorities.
• Strong written and verbal communication and interpersonal skills to collaborate cross-functionally and with external stakeholders.
• Experience with credentialing software and databases (preferred).

Benefits

Additional Information

Akido builds AI-powered doctors . Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America's physician shortage and make exceptional healthcare universal. Its AI empowers doctors to deliver faster, more accurate, and more compassionate care. Serving 500K+ patients across California, Rhode Island, and New York, Akido offers primary and specialty care in 26 specialties-from serving unhoused communities in Los Angeles to ride-share drivers in New York. Founded in 2015 (YC W15), Akido is expanding its risk-bearing care models and scaling ScopeAI, its breakthrough clinical AI platform. Read more about Akido's $60M Series B . More info at Akidolabs.com .

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