Provider Enrollment Specialist II

About Altais: At Altais, we’re on a mission to improve the healthcare experience for everyone—starting with the people who deliver it. We believe physicians should spend more time with patients and less time on administrative tasks. Through smarter technology, purpose-built tools, and a team-based model of care, we help doctors do what they do best: care for people. Altais includes a network of physician-led organizations across California, including Brown & Toland Physicians, Altais Medical Group Riverside, and Family Care Specialists. Together, we’re building a stronger, more connected healthcare system. About the Role Are you looking to join a fast-growing, dynamic team? We’re a collaborative, purpose-driven group that’s passionate about transforming healthcare from the inside out. At Altais, we support one another, adapt quickly, and work with integrity as we build a better experience for physicians and their patients. The Provider Enrollment Specialist II supports Family Care Specialists (FCS), Altais Medical Group Riverside (AMGR), and Altais Medical Group Bay Area (AMGBA) by independently managing the full lifecycle of provider credentialing, recredentialing, and payer enrollment. This role ensures compliance with AMG policies, health plan delegation requirements, NCQA standards, and government payer rules while maintaining accurate and up‑ to ‑ date provider information across systems, portals, and payer platforms. The Provider Enrollment Specialist II handles moderately complex enrollment issues, works collaboratively across departments, and supports efficient onboarding to avoid revenue disruption. You will focus on: Payer Enrollment & RCM ‑ Aligned Responsibilities Manage and coordinate all aspects of payer enrollment for new and existing providers, including tracking progress, deadlines, and payer requirements. Verify group ‑ level versus provider ‑ level contracts to confirm enrollment steps required by each payer. Complete and submit payer enrollment applications (including signature ‑ required forms) and perform proactive follow ‑ up to expedite approvals. Utilize payer portals to submit information, track status, manage rosters, and complete provider demographic updates, location changes, and revalidations. Utilize Athena practice management to identify enrollment issues, and complete tasks related to provider configuration. Communicate provider changes to contracted health plans and FCS, AMGR, and AMGBA management via standardized reports. Government Payer Maintenance (CMS / DHCS) Manage Medicare revalidation cycles and submit updates through PECOS. Perform annual Medi ‑ Cal renewals and maintain records in PAVE. EHR & System Collaboration Work within the EHR/practice management system (Athena) to identify , troubleshoot, and resolve enrollment ‑ related issues. Collaborate with IT/EHR analysts, Revenue Cycle, and Operations to correct provider setup, payer participation mapping, NPI/taxonomy assignments, and other configuration components required for clean claim submission. Independently troubleshoot complex EHR enrollment errors to prevent billing delays. Credentialing & Recredentialing Responsible for all aspects of credentialing/recredentialing providers, including verification of applications and documents, mailing of requests for consideration, preparing initial applications, issuing approval/denial/termination letters, and accurately loading provider information in credentialing databases. Process credentialing and recredentialing applications accurately and promptly in accordance with FCS, AMGR, and AMGBA policies, health plan delegation requirements, and NCQA standards. Perform credentialing for health plans, hospital medical staff, and surgery centers. Track and maintain renewal ‑ based provider credentials, including licenses, DEA registrations, board certifications, malpractice coverage, and other compliance documents. Disseminate new or modified professional information to FCS, AMGR, and AMGBA providers and departments. Coordinate credentialing and recredentialing task grids and tickler systems to ensure follow ‑ up and timely completion. Data Management, Compliance & Audits Responsible for accurate input, updates, and modifications to the credentialing database; perform routine audits to assure accuracy. Review state and federal sanctions bulletins and update provider files accordingly. Prepare materials for external audits by payors and governmental agencies; ensure files remain audit ‑ ready. Maintain up ‑ to ‑ date records across internal databases, CAQH, PECOS, PAVE, payer portals, and contract files. Administrative Coordination & Communication Coordinate responses to payer inquiries; follow up with payers and providers to completion. Maintain effective communication with health plan representatives and AMG departments. Participate in training sessions related to payer enrollment and credentialing workflows; collaborate with team members to meet weekly enrollment goals. The Skills, Experience & Education You Bring ​ High school diploma or equivalent 3–5 years of healthcare credentialing and payer enrollment experience; IPA, physician group, or Revenue Cycle experience preferred. Excellent computer skills, including Microsoft Office (Word, Outlook, Excel, PowerPoint). Ability to use independent judgment and initiative within established policies and procedures. Strong relationship ‑ building skills across all levels of staff, management, and external payer contacts. Excellent written and verbal communication skills. Exceptional organizational skills and the ability to manage multiple projects concurrently. Ability to obtain, synthesize, and analyze data and recommend solutions. Ability to draft presentations, handouts, and communications. Demonstrates a learning and growth mindset; proactive and solution ‑ oriented. Preferred Certifications Certified Provider Credentialing Specialist (CPCS) preferred. National Association Medical Staff Services (NAMSS) coursework or certification preferred. The Base Salary for this position is $21.00 - $25.00/hr In addition, we provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs. Excellent medical, vision, and dental coverage 401k savings plan with a company match Flexible time off and 9 Paid Holidays You Share Our Mission & Values: Compassion We act with empathy and a deep respect for the challenges faced by physicians and their patients. Our work is driven by a genuine commitment to improving lives and ensuring that care is delivered with dignity, understanding, and humanity. Community We foster a culture of collaboration --with physicians, patients across the healthcare ecosystem, and among our teams. By building strong, trusted relationships, we create a unified community focused on advancing patient care and physician well-being. Leadership We lead with integrity and vision, setting the standard for excellence in physician support and healthcare innovation. Through collaboration and expertise , we empower others to lead, drive change, and shape the future of care. Excellence We are relentlessly focused, results-driven, and accountable for delivering measurable value to physicians and the patients they serve. Our high standards reflect our commitment to excellence, operational discipline, and continuous improvement. Agility We embrace change as a constant and respond swiftly to the evolving needs of the healthcare industry. With flexibility and forward-thinking, we adapt, innovate, and act decisively to keep physicians at the forefront. Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate’s starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs. The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate’s qualifications, skills, and experience. Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our ‘CPRA Privacy Notice for California Employees and Applicants’ to learn how we collect and process your personal information when you apply for a role with us. External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.