Provider Enrollment and Credentialing Representative

Tasks

• Conduct background investigation
• Ensure payer compliance
• Initiate credential files
• Maintain CAQH files
• Maintain physician certification requirements
• Obtain medical licenses
• Perform primary source verification
• Prepare credentials files for committees
• Process provider enrollment requests
• Review practitioner applications
• Validate eligibility and discrepancies
• Verify physician credentials

Perks/Benefits

• Great Place to Work certified employer
• Supportive and inclusive environment

Skills/Tech-stack

CAQH | Credentialing | Insurance billing | Licensing | Medical terminology | Primary Source Verification | Source verification