Top 284 Provider enrollment Jobs in Baltimore, Md

Provider Credentialing Specialist I (Remote) - Dental
CareFirst BlueCross BlueShield —Baltimore, MD
- $38,520 - $70,620 a year
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- 401(k)
Quick Apply
3d
Enrollment Provider & Credentialing Consultant
Solutions Technology, Inc / STI Health & Wellness —Odenton, MD
- $23.89 - $28.51 an hour
- Part-time
- Mid-level
- High school diploma or GED
- Bachelor's degree
13d
Enrollment Coordinator
ST VINCENT DE PAUL OF BALTIMORE INC —Baltimore, MD
- $19 - $22 an hour
- Part-time
- Microsoft Outlook
- Mid-level
- Office
Quick Apply
HIV Nurse Practitioner
Chase Brexton Health Care —Baltimore, MD
- $115,202.50 - $140,000.00 a year
- Full-time
- Mid-level
- Office
Quick Apply
HIV Nurse Practitioner/Physician Assistant
Chase Brexton Health Care —Baltimore, MD
- $100,000 - $140,000 a year
- Full-time
- Mid-level
- Office
- 3 years
Quick Apply
HIV Nurse Practitioner
Chase Brexton Health Care —Columbia, MD
- $115,202.50 - $140,000.00 a year
- Full-time
- Mid-level
- Office
Quick Apply
Benefits Specialist
Harkins Builders —Columbia, MD
- $70,000 - $80,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Profit sharing
- Paid jury duty
Patient Care Coordinator
Unified Women's Healthcare —Maryland
- Full-time
- Hybrid work
- Microsoft Outlook
- Medical office experience
- Mid-level
- Commuter assistance
- Paid parental leave
Senior Clinical Nurse I, Nights, Emergency Dept - MTC
University of Maryland Medical System —Baltimore, MD
- Full-time
- Nursing
- RN License
- Bachelor of Science
Pharmacy Technician Clinical Coordinator
MedStar Health —Elkridge, MD
- $22.48 - $39.75 an hour
- Full-time
- Customer service
- Research
- Mid-level
Physical Therapist Assistant - Central AA County
Amedisys —Glen Burnie, MD
- $43 - $53 an hour
- Full-time
- CPR Certification
- BLS Certification
- Physical & Rehabilitation Medicine
- Mileage reimbursement
- Paid parental leave
13d
Office Manager/Bookkeeper
Vital Business Solutions —Beltsville, MD
- $52,000 - $72,000 a year
- Email
- OSHA
- Pass drug screening
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
10d
Site Director at Yorktown Elementary
KinderCare Education —Bowie, MD
- $20.25 - $28.35 an hour
- Full-time
- Classroom
- Customer service
- Computer literacy
- Health insurance
- Dental insurance
5d
AOT Case Manager
Lead4Life, Inc. —Glen Burnie, MD
- $60,000 - $70,000 a year
- Full-time
- Background check
- Spanish
- CPR Certification
Quick Apply
6d
Experienced Dermatology Physician Assistant
U.S. Dermatology Partners —Annapolis, MD
- $120,000 - $170,000 a year
- 8 hour shift
- Mid-level
- Patient care
- US work authorization
- Health savings account
- Health insurance
Quick Apply
6d
Regional Account Executive
Rentokil North America —Baltimore, MD
- $38,000 - $70,000 a year
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Profit sharing
- Paid holidays
Quick Apply
Regional Account Executive
Rentokil North America —Baltimore, MD
- $38,000 - $700,000 a year
- Full-time
- Background check
- Microsoft Excel
- Writing skills
- Profit sharing
- Paid holidays
Quick Apply
Teachers at Kensington KinderCare
KinderCare Education —Abingdon, MD
- $15.60 an hour
- Full-time
- Classroom
- CPR Certification
- Customer service
- Health insurance
- Dental insurance
5d
Teachers at Calverton KinderCare
KinderCare Education —Beltsville, MD
- $16.60 an hour
- Full-time
- Classroom
- CPR Certification
- Customer service
- Health insurance
- Dental insurance
5d
Medical Billing Assistant
OneSource RCM LLC —Baltimore County, MD
- $2,000 - $3,000 a month
- Part-time
- Hybrid work
- Background check
- Microsoft Outlook
- Computer literacy
Quick Apply
7d

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provider enrollment jobs near baltimore, md

Provider Credentialing Specialist I (Remote) - Dental

CareFirst BlueCross BlueShield -
Baltimore, MD

Quick Apply

Job Details

Full-time
$38,520 - $70,620 a year
3 days ago

Benefits

401(k)

Qualifications

Customer communication
Spreadsheets
Providing information to customers
Employee relationship building
High school diploma or GED
Internal employee customer service
Stakeholder relationship building
Excel data analysis

Full Job Description

Resp & Qualifications

PURPOSE:

This role will credential practitioners for network participation with CareFirst BlueCross BlueShield and accurately maintain all provider data within the enterprise-wide Provider file to supply the organization with provider data, while ensuring compliance with regulatory, accreditation, legal and company requirements and standards.

ESSENTIAL FUNCTIONS:

Analyzes credentialing applications to perform the primary source verification of the appropriate credentials in order for a practitioner to participate in the CareFirst networks. Once verified, accepted and approved, determines the appropriate networks for participation and obtains the appropriate executed contracts to effectuate the professional relationship and structures the provider group accordingly.
Responds to external and internal inquiries regarding provider participation eligibility and criteria, participation status, credentialing, contractual status and provider file updates. Direct focus on the provider experience, providing timely resolution dependable follow-up and proactive measures to ensure successful credentialing is achieved. Professional etiquette, communications and sound decision making is required.
Maintains the provider file, the Provider Information Control (PICS) inventory workflow system and electronic provider files with updated provider information during processes, such as credentialing, recredentialing, demographic updates, terminations and all other provider file maintenance activities.
Responsible for identifying, analyzing and resolving immediate and existing provider file issues. Processes provider file inputs in accordance with applicable state laws and departmental guidelines. Verification of provider data and system release entered into the provider file database, ensuring a successful integration with the other corporate systems.
Prepares written responses to obtain incomplete or missing information and or communicates effectively telephonically.

QUALIFICATIONS:

Education Level: High School Diploma or GED.

Licenses/Certifications Preferred:

Certified Provider Credentialing Specialist (CPCS).

Experience: 3 years physician credentialing experience or health insurance/managed care operations experience in a customer service, claims, billing and enrollment, or call center environment.

Preferred Qualifications:

Bachelor Degree in Business, Healthcare Administration or related field.

Knowledge, Skills and Abilities (KSAs)

Must be proficient in the use of Excel spreadsheets, and an understanding of Pivot tables.
Excellent verbal and written communication and interpersonal skills. Ability to develop and maintain effective relationships with peers, physicians, and medical staff to create confidence, respect and dependability.
Knowledge of medical terminology.
Demonstrated proficiency utilizing reference materials and ability to follow Standard Operating procedures to reduce risk and ensure provider data accuracy and overall quality.
Ability to understand jurisdictional requirements and the legal ramifications of the credentialing and provider file maintenance processes and interpret reasoning for performing verification and/or appropriate actions.

Salary Range: $38,520 - $70,620

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

#LI-LJ1

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Refine Your Search

provider enrollment jobs in baltimore, md

Provider Credentialing Specialist I (Remote) - Dental

Enrollment Provider & Credentialing Consultant

Enrollment Coordinator

HIV Nurse Practitioner

HIV Nurse Practitioner/Physician Assistant

HIV Nurse Practitioner

Benefits Specialist

Patient Care Coordinator

Senior Clinical Nurse I, Nights, Emergency Dept - MTC

Pharmacy Technician Clinical Coordinator

Physical Therapist Assistant - Central AA County

Office Manager/Bookkeeper

Site Director at Yorktown Elementary

AOT Case Manager

Experienced Dermatology Physician Assistant

Regional Account Executive

Regional Account Executive

Teachers at Kensington KinderCare

Teachers at Calverton KinderCare

Medical Billing Assistant

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