Provider Enrollment Specialist II

Altais is a California-based healthcare organization supporting physician-led medical groups through technology, operational expertise, and coordinated care solutions. The Provider Enrollment Specialist II manages the full lifecycle of provider credentialing, recredentialing, and payer enrollment to ensure regulatory compliance and uninterrupted revenue operations. This role collaborates across departments to maintain accurate provider data, resolve enrollment issues, and support audit readiness.

Altais is seeking a Provider Enrollment Specialist II to independently manage provider credentialing, recredentialing, and payer enrollment processes across affiliated medical groups. This role ensures compliance with NCQA standards, government payer regulations, and health plan delegation requirements while supporting revenue continuity and operational accuracy.

Responsibilities:
- Manage end-to-end payer enrollment for new and existing providers, including application submission and follow-up
- Oversee Medicare revalidations through PECOS and Medi-Cal renewals through PAVE
- Perform credentialing and recredentialing processes in compliance with internal policies and regulatory standards
- Maintain accurate provider data across credentialing databases, CAQH, payer portals, and internal systems
- Collaborate with Revenue Cycle, IT, and Operations to resolve enrollment-related EHR configuration issues
- Prepare documentation for external audits and maintain audit-ready credentialing files

Requirements:
- High school diploma or equivalent
- 3–5 years of healthcare credentialing and payer enrollment experience
- Experience with government payers, NCQA standards, and provider data management
- Strong proficiency in Microsoft Office applications
- Excellent organizational, analytical, and communication skills
- Ability to manage multiple projects and meet regulatory deadlines

Benefits:
- Competitive hourly compensation
- Medical, dental, and vision coverage
- 401(k) with company match
- Flexible time off and paid holidays

This role requires strong regulatory knowledge, data accuracy, and cross-functional collaboration to support efficient provider onboarding and compliance management.