Job Summary
We are seeking a detail-oriented Healthcare Credentialing / Provider Enrollment Specialist to join our team. The ideal candidate will be responsible for ensuring that all healthcare providers meet the necessary qualifications and comply with governmental and commercial healthcare insurance payors.
Essential Functions
- Process credentialing and recredentialing applications for health care providers.
- Completes, reviews and verifies credentialing applications.
- Calls Insurance companies to request Network participation
- Loads and maintains provider information in a credentialing database system.
- Track license and certification expirations for medical providers to ensure timely renewals.
- Handle and resolve inquiries regarding credentialing information, process and/or status.
- Perform new account setup
- Perform the Month End Report process for all clients. Initiate, verify, collate and complete.
- Create new users and maintain access to multiple insurance portals.
- Enroll and Maintain ERA and EFT submissions.
- Update budget reports daily
- Process attestation requests from Insurance companies
- Perform miscellaneous administrative tasks
- Other duties as requested
Skills, Knowledge and Experience Required
- Strong Organizational Skills: Must keep track of multiple strict deadlines and ensure that all the required documentation is in order.
- Attention to Detail: Responsible for verifying credentials, it is essential for this position to have a strong attention to detail.
- Strong Medicaid and Medicare knowledge.
- Strong commercial payor knowledge.
- Technical Skills: Credentialing and Enrollment Software. Preferred knowledge of the ECHO and Modio software, not a requirement.
- Communication Skills: Effective communication with providers, other staff members within the organization and with insurance representatives.
- Strong Research Skills: Ability to research provider backgrounds, payor inquire and notifications or other topics on a regular basis.
- Proficiency: Related to credentialing standards and procedures
If you are a meticulous individual with a background in credentialing, provider enrollment and a passion for maintaining quality standards in healthcare, we encourage you to apply for this rewarding opportunity as a Credentialing Specialist.
Pay: $24.00 - $30.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
