Credentialing and Provider Enrollment Specialist
Tasks
- Apply for license renewals
- Communicate credentialing updates to providers
- Complete provider enrollment applications
- Ensure compliance with state federal and payer credentialing requirements
- Follow SOPs and policies for compliance
- Follow up with health plans and hospitals
- Maintain credentialing data quality expiration dates and contact information
- Maintain provider database in MD Staff
- Monitor application timelines
- Process credentialing recredentialing and privileging applications
- Resolve credentialing issues with health plans
- Serve as liaison for payers hospitals and credentialing verification organizations
Perks/Benefits
Skills/Tech-stack
Application processing | Credentialing | Data Quality | Database Management | MD Staff | Medicaid | Medicare | NCQA | Payer requirements | Problem Solving | Process compliance | Provider enrollment | SOP compliance | Verbal communication | Written communication
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