Payer Enrollment & Credentialing Specialist

100% Remote

Please Apply Only If You Have 3 Years Experience Completing Medicare and Medicaid Payer Credentialing Applications

Join AIS Healthcare

AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion Care solutions. Guided by our core values of Innovation, Stewardship, and Unity, we are committed to Advancing Quality and Improving Lives for the patients, providers, and communities we serve.

We are seeking an experienced Payer Enrollment & Credentialing Specialist to join our growing team. This role is ideal for a credentialing professional who is highly organized, detail-oriented, and experienced in managing payer enrollment and credentialing applications from submission through approval.

If you have experience navigating Medicare and Medicaid enrollment processes, working with credentialing databases, and managing multiple payer applications simultaneously, we'd love to hear from you.

Why Join AIS Healthcare?

We offer a comprehensive benefits package, including:

100% Remote Work Opportunity
Medical, Dental, and Vision Insurance
Company-Paid Life Insurance
Long-Term Disability Insurance
Generous Paid Time Off
401(k) with Generous Employer Match
Career Growth Opportunities
Supportive and Collaborative Team Environment

Position Summary

The Payer Enrollment & Credentialing Specialist is responsible for supporting the end-to-end payer credentialing lifecycle for a national network of home infusion pharmacies, specialty pharmacies, infusion centers, and affiliated clinical providers.

This position coordinates credentialing and recredentialing activities, validates provider and organizational data, maintains credentialing records, and ensures all required documentation meets payer, regulatory, and accreditation standards. The role is critical to maintaining active network participation and preventing service disruptions related to credentialing gaps.

What You'll Do

Coordinate payer credentialing and recredentialing activities for specialty pharmacies, infusion centers, and affiliated providers
Prepare, complete, and submit payer enrollment and credentialing applications accurately and within established deadlines
Manage Medicare and Medicaid enrollment and revalidation submissions
Maintain organized records of licenses, accreditations, insurance documents, provider credentials, and enrollment documentation
Serve as the primary point of contact for payer credentialing departments regarding application statuses, delays, and resolution of issues
Monitor credentialing milestones and maintain accurate records within Salesforce and credentialing databases
Track application progress and proactively communicate updates to internal stakeholders
Maintain detailed documentation to satisfy commercial, government, and third-party payer requirements
Ensure provider information is accurate and consistent across credentialing platforms and payer applications
Support compliance with regulatory, accreditation, and contractual requirements
Protect patient privacy and maintain confidentiality in accordance with HIPAA guidelines
Assist with special projects and additional duties as assigned

Required Qualifications

Minimum of 3 years of payer credentialing experience
Experience completing payer credentialing applications through multiple submission methods
Experience with Medicare and Medicaid payer enrollment processes
Experience working within home infusion, specialty pharmacy, provider services, or healthcare organizations
Working knowledge of:
- CAQH
- PECOS
- NPPES
- NCPDP
Ability to interpret and utilize provider taxonomy codes, NPIs, and other provider identifiers
Experience managing multiple applications simultaneously while meeting deadlines
Strong organizational skills and attention to detail
Excellent verbal and written communication skills
Ability to work independently in a remote environment
Proficiency with Microsoft Outlook, Word, Excel, and SharePoint

Preferred Qualifications

Medicare and Medicaid enrollment and revalidation experience
Home Infusion experience
Specialty Pharmacy experience
Experience navigating contract management software
Experience supporting provider and organizational credentialing initiatives across multiple states

How to Apply

To be considered for this position, you must complete the Culture Index Assessment.

Culture Index Assessment:
http://portal.cultureindex.com/public/survey/general/0BFB8F0000

Important: Applications will not be reviewed until the assessment has been completed.

If the assessment link does not open when clicked, please copy and paste the URL directly into your browser. If you continue to experience issues, try using a different browser.

About AIS Healthcare

AIS Healthcare is the nation's leading provider of advanced sterile, patient-specific intrathecal pump medications and in-home infusion therapies. Through innovative pharmacy services, specialized nursing support, and comprehensive care coordination, we help providers deliver exceptional patient care and outcomes.

We're looking for positive, hardworking professionals who are passionate about making a difference in the lives of patients and providers.

Payer Enrollment & Credentialing Specialist - Medicare/Medicaid