Credentialing and Provider Enrollment Specialist
Tasks
- Apply for license renewals
- Communicate credentialing updates with providers
- Complete provider enrollment applications
- Ensure state federal and payer credentialing compliance
- Follow SOPs and compliance policies
- Follow up with health plans and hospitals
- Maintain credentialing data quality
- Maintain provider data in MD Staff
- Monitor application timelines
- Process credentialing and privileging applications
- Resolve credentialing issues with IPAs and health plans
- Serve as liaison to payers hospitals and credentialing verification organizations
Perks/Benefits
Skills/Tech-stack
Application processing | Credentialing | Database Management | MD Staff | Medicaid | Medicare | NCQA | Process compliance | Provider enrollment
Education
Related jobs
-
Enrollment Specialist - 10959 USD 42K-53KApplication processing | Customer Service | Data Management | Data entry | EHR9 holidays | Basic Life and AD And D Insurance | Dental insurance | Employee assistance program | Flexible spending accountsMid-level Full TimeDenver, CO2d ago
-
Graduation Specialist, College of Engineering and Computer Science (Student Services Professional III) USD 66K-94KAcademic advising | Case management | Conflict Resolution | Data Analysis | Data reportingDental coverage | Disability insurance | Health insurance | Life insurance | Paid time offSenior-level Full TimeSouthern California, Fullerton2d ago
-
Accreditation | Business Rules | Data Sharing | NC Tracks | Policy coordinationHealth insurance coverage under High Deductible Health Plan | No leave benefitsSenior-level Full Time Temporary1915 Health Services Way Wake, United …2d ago
-
Enrollment Services Assistant I USD 40K-45KAccess | CRM | Customer Service | Database Management | Excel10 month flex position | Flexible schedule | Paid time off in July and August | Remote-friendlyEntry-level Full TimeMichigan, East Lansing3d ago
-
Provider Enrollment Specialist USD 42K-64KAcrobat Pro | Adobe Acrobat | Adobe Acrobat Pro | CAQH | Commercial InsuranceEntry-level Full TimeShriners Children's - Headquarters, United States3d ago
-
Compliance | Coverage Verification | Credentialing | Credentialing database | Data verificationRelocation support if required | Remote work possibleMid-level Full TimeRemote, United States R3d ago
-
FranU Enrollment Operations Specialist USD 70K-80KAcademic credit evaluation | Application processing | CRM | Credit Evaluation | Customer Relationship ManagementFlexible work hours | Travel opportunity | Valid driver license requiredExecutive-level Full TimeBaton Rouge, LA, United States4d ago
-
TIP Enrollment Specialist USD 32K-38KCustomer Service | Data Analysis | Data entry | Database Management | Email communicationComprehensive benefits package | Generous time off | Paid travel | Tuition remissionEntry-level Full TimeWaco, TX, United States4d ago
-
Clinical nutrition | Database Management | Menu development | Nutrition | Recipe developmentSenior-level Full TimeHouston, TX4d ago
-
Specialist Healthcare Enrollment USD 74K-108KACA Compliance | Charity Care | Data entry | Data interchange | EDI403b retirement plan options | Employee assistance program | Federal Student Loan Forgiveness | Health and wellness programs | Life insuranceMid-level Part TimePaterson, NJ, United States5d ago
-
Eligibility Enrollment CSR/Processor USD 34K-44KAppeals Processing | Attention to detail | Credential Verification | Customer Service | Data entry401k plan | Annual pay increases | Dental insurance | Health insurance | Life insuranceMid-level Full TimeMurray, UT, USA5d ago
-
Adobe Acrobat | Case management | Eligibility determination | Health insurance | Identity verificationDeferred compensation | Disability coverage | Flexible spending account options | Health insurance | Life insuranceEntry-level Full TimeSalem | OHA | Summer Street, …5d ago
-
Credentialing & Enrollment Specialist USD 62K-70KCAQH | Compliance | Credentialing | Database Management | Documentation ManagementRemote workMid-level Full TimeNew York, NY8d ago
-
AthenaOne EMR | CredentialStream | Credentialing | HIPAA | Medicaid401k | Dental insurance | Expense Reimbursement for Home Office | Health insurance | Life insuranceEntry-level Full TimeRemote, USA, United States R8d ago
-
Enrollment Specialist USD 40K-48KCBMS | Case management | Colorado Medicaid | Customer Service | Data entry401k match | Career growth opportunities | Dental insurance | Employee resource groups | Health insuranceMid-level Full TimeDenver, CO, United States8d ago
-
Credentialist - Provider Enrollment Specialist USD 36K-40KCredentialing | DEA Compliance | Insurance compliance | License Management | Medical billingFully remote | Opportunities for growth | Weekends off | Work-life balanceMid-level Full TimeToledo, Ohio, United States R9d ago
-
Payor Enrollment Specialist USD 41K-56KCredentialing | Data Management | Enrollment Management | Payer Portals | ReportingMid-level Full TimeTallahassee, FL, United States9d ago
-
Provider Enrollment Specialist USD 34K-52KCustomer Service | Data entry | Database Management | Microsoft Office | Verbal communicationEntry-level Full TimeAllentown, PA - 1110 American Parkway, …9d ago
-
Provider Enrollment & Credentialing Specialist USD 48K-66KCAQH | Credentialing | Credentialing software | HIPAA | Healthcare administrationEducation reimbursement | Employee recognition | Life insurance | Paid Holidays | Paid time offMid-level Full TimeCharlotte, NC, US9d ago
-
Enrollment Lead USD 60K-80KCAQH | Commercial Enrollment | Delegated Credentialing | Documentation | Enrollment Portals401k matching | Company sponsored offsite travel | Employee wellness program | Free therapy | Hardware or software allowanceSenior-level Full TimeUS - Remote R10d ago
-
Credentialing & Enrollment Specialist USD 57K-62KAthena EMR | Credentialing | Google Sheets | HIPAA | Hospital CredentialingMid-level Full TimeHouston, TX, United States R10d ago
-
AthenaOne | AthenaOne EMR | CredentialStream | Credentialing | HIPAA401k | Dental insurance | Expense Reimbursement for Home Office | Health insurance | Life insuranceEntry-level Full TimeRemote, USA, United States R11d ago
-
Enrollment Specialist USD 40K-48KApplication processing | CBMS | Case management | Colorado Medicaid | Customer Service401k match | Career growth opportunities | Dental insurance | Employee resource groups | Health insuranceMid-level Full TimeDenver, CO, United States11d ago
-
Provider Enrollment Specialist USD 48K-56KCAQH | Fee Schedules | HIPAA | MS Office | Managed care401k | Career growth | Child care assistance | Continuing education funds | Dental insuranceMid-level Full TimeTEMPE, AZ, United States11d ago
-
Enrollment Specialist (New Jersey) USD 50K-55KAthena EMR | AthenaOne | Claims Processing | CredentialStream | Credentialing401k | Dental insurance | Expense reimbursement | Life insurance | Medical insuranceEntry-level Full TimeRemote, USA, United States R12d ago