Credentialing & Provider Enrollment Manager
Tasks
- Ensure credentialing files CAQH profiles and payer applications compliant
- Generate reports and dashboards for credentialing TAT and payer status
- Implement process improvements for credentialing operations
- Lead and mentor credentialing specialists
- Maintain CAQH profile accuracy
- Manage end to end provider credentialing
- Manage payer applications
- Manage provider re credentialing
- Oversee provider enrollment with Medicare Medicaid and commercial payers
- Provide client updates and resolve escalations
- Set goals and SLAs for credentialing team
- Track enrollment timelines and identify bottlenecks
Perks/Benefits
Skills/Tech-stack
Availity | CAQH | Credentialing | Google Sheets | MS Excel | Medicaid | Medicare | PECOS | Payer requirements | Provider enrollment
Education
N/A
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