Top 6 Credentialing specialist Jobs in Durham, Nc

Provider Enrollment Specialist (Full Time, Remote, North Carolina Based)
Alliance Health —Morrisville, NC
- $23.36 - $29.78 an hour
- Full-time
- Remote
- Writing skills
- Mid-level
- Administrative experience
- Disability insurance
- Health insurance
2d
Credentialing Services Specialist
Dean Dorton —Raleigh, NC
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Customer service
- Profit sharing
- Wellness program
Quick Apply
8d
CCC Specialist I
American Board of Anesthesiology Inc —Raleigh, NC
- Full-time
- Writing skills
- Research
- Mid-level
Quick Apply

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Provider Enrollment Specialist (Full Time, Remote, North Carolina Based)

Alliance Health -
Morrisville, NC

Apply Now

Job Details

Full-time
$23.36 - $29.78 an hour
2 days ago

Benefits

Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance
Flexible schedule
Retirement plan

Qualifications

Administrative experience

Full Job Description

The Provider Enrollment Specialist ensures that all providers in the Alliance Health Network are enrolled in NCTracks with an active Medicaid Health Plan and a valid taxonomy for the service requested; reviews Provider Action Database to identify any providers for exclusion from the network. Specialists will only approve applications for services identified as a network need and/or services mandated by compliance with Parity.

This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into the Alliance Office for business and team meetings as needed.

Responsibilities & Duties

Review, Respond, and Process all Provider Application Requests and Notice of Change Requests

Monitor and respond to provider inquiries received via the Enrollment email Inbox and phone queue

Review NC Tracks to confirm the following:
- NPI enrollment
- Site enrollment
- Approved Taxonomy for service requested
- Valid Health Plan enrollment

Review Alliance Health Provider Action Database for provider exclusions
Notify Contracts of approved additions and/or needed changes to contract
Complete written notice to providers regarding enrollment and contracting decisions per procedures
Meet all identified turn around times for provider enrollment responses
Verify that all NC Tracks information is reflected accurately in the ACS system based on the Provider Enrollment file
Ensure that all departments that are affected by any enrollment changes are notified timely and according to policy and procedure

Track Provider Applications Requests and Notices of Change

Track all provider requests and outcomes per department procedure

Minimum Requirements

Education & Experience

Required:

High school diploma/GED and six (6) years of experience in an administrative support role in healthcare

Bachelor’s degree from an accredited College or University and two (2) years of experience in an administrative support role in healthcare.

Preferred:

Behavioral Health experience preferred

Experience with NCTracks preferred.

Two years experience in provider enrollment preferred.

Knowledge, Skills, & Abilities

Knowledge of the organization and it’s functions
Knowledge of NCTracks system
Knowledge of computerized record-keeping techniques
Knowledge of and experience with records, reports and file maintenance.
Proficient with Microsoft Office suite
Proficient with grammar, spelling, punctuation and vocabulary
Skilled at organizing work to meet schedules and timelines
Ability to communicate effectively both in oral and written form
Ability to understand and follow oral and written directions
Ability to exercise tact and discretion in working with confidential or sensitive information
Ability to work independently with little direction
Ability to establish and maintain effective working relationships with others
Ability to analyze situations accurately and adopt an effective course of action

Salary Range

$23.36 - $29.78/ Hourly

Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity

An excellent fringe benefit package accompanies the salary, which includes:

Medical, Dental, Vision, Life, Long Term Disability
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility

Education

Required

High School or better in General Studies

Skills

Required

Communication
Microsoft Office
Organizing
Tact
Time Management

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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credentialing specialist jobs in durham, nc

Provider Enrollment Specialist (Full Time, Remote, North Carolina Based)

Credentialing Services Specialist

CCC Specialist I

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