Interim Provider Enrollment Specialist/Coordinator

The Greeley Company, LLC - United States3.0

ContractEstimated: $31,000 - $42,000 a year
EducationSkills

The Greeley Company, LLC is a highly regarded professional services organization with 30+ years of history partnering with hospitals and healthcare organizations nationwide. Within our Interim Staffing Services, we can react quickly to the critical and urgent needs for quality medical staff service professionals who are trained and experienced providing support to our clients.

Currently our team is recruiting for experienced interim Provider Enrollment Specialists/Coordinators to join our organization as independent contractors (1099) supporting the Medical Staff Services Departments for our clients located nationwide. If you are interested in becoming an interim Provider Enrollment Specialist/Coordinator for our organization, we guarantee you will find it exciting and rewarding.

Responsibilities:

· Ensure the integrity of and carry out the enrollment process in accordance of our hospital's policies & procedures

· Process enrollment applications for both government/commercial health plan payors, and manage the ongoing participation requirements of the plans for all practitioners enrolled

· Populate, maintain, and update the credentialing software to ensure accountability for the integrity of information enter into the system

· Access external databases to obtain primary source documents necessary to complete payor applications according to organizational policy

· Ensure current versions of forms are used for the provider enrollment function

· Generate and reply to correspondence related to provider enrollment

· Interact with representatives from health plans to answer inquiries and clarify requirements

· Facilitate obtaining practitioner licenses, DEAs, NPI numbers, etc.

Experience:

· Knowledge of federal and state regulatory requirements and accreditation standards (i.e. TJC, NCQA, DNV, and CMS)

· Understanding of medical terminology, including Medicare and Medicaid, and other commercial payers (BCBS, Aetna, etc.)

· Ability to work independently with minimal supervision, strong organizational and time management skills

· Recent experience with insurance enrollment software systems (OneApp, CAQH, PECOS, etc.)

· Credentialing software a huge plus specifically MDStaff

Required Qualifications:

· High school diploma or equivalent.

· Associates Degree preferred

· 3+ years of experience within Medical Staff Services as credentialing/privileging specialist/coordinator

· 3+ years of experience within in-patient hospital environment

· CPCS, CPMSM certification preferred

Job Type: Contract

Experience:

  • relevant: 3 years (Preferred)

Required travel:

  • 75% (Required)

Contract Renewal:

  • Likely

Work Location:

  • Multiple locations