Provider Enrollment & Credentialing Specialist
Tasks
- Collect provider signatures and documentation
- Coordinate provider enrollment and re enrollment
- Coordinate provider reappointment
- Escalate credentialing and enrollment concerns
- Follow up with payors facilities and providers
- Initiate corrective actions
- Maintain credentialing and enrollment records
- Maintain physician credentialing files
- Monitor credentialing and enrollment deadlines
- Monitor payor enrollment applications
- Prepare credentialing status reports
- Prepare payor enrollment applications
- Process provider terminations
- Respond to provider and payor inquiries
- Review provider profiles for discrepancies
- Submit payor enrollment applications
- Support HIPAA compliance
- Track application status
- Update provider demographic information
Perks/Benefits
- Education reimbursement
- Employee recognition
- Life insurance
- Paid Holidays
- Paid time off
- Profit sharing
- Retirement plan
- Team building events
Skills/Tech-stack
CAQH | Credentialing | Credentialing software | HIPAA | Healthcare administration | Medical Staff | Medical Staff Services | Microsoft Excel | Microsoft Outlook | Microsoft Word | NPPES) | PECOS | Payor Enrollment | Payor portals
Education
Regions
Countries
States
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