4 Credentialing and Enrollment Specialist Jobs in Camden, NJ
CAMcare Health Corporation is Hiring a Credentialing and Enrollment Specialist Near Camden, NJ
provide the best possible healthcare to communities in Camden and the surrounding areas. We live our values by providing primary health care to everyone regardless of their ability to pay at seven sites throughout Camden and Gloucester counties. Focused on leveling up patient care, we are incorporating technology, creative problem solving, and innovating healthcare every day.
How you can make an impact: As a Credentialing and Enrollment Specialist, you will be responsible for ensuring that healthcare providers are properly credentialed and enrolled with insurance companies and government healthcare programs. You will play a crucial role in maintaining compliance with regulatory standards and ensuring that healthcare services can be reimbursed efficiently. This position requires meticulous attention to detail, excellent organizational skills, and a strong understanding of healthcare regulations and insurance processes.
What You Will Do Credentialing Process:
- Manage the credentialing process for healthcare providers, including physicians, nurses, and other allied health professionals.
- Collect and verify all necessary documentation for credentialing applications.
- Communicate with providers to obtain any missing or updated information.
- Submit credential applications to insurance companies and other relevant entities.
- Monitor the status of credentialing applications and follow up as needed to ensure timely completion.
- Review regulatory and disciplinary action reports issued by State licensure bodies, Federal agents and the Office of Inspector General Medicaid and Medicare Sanctions report (OIG), National Practitioner Data Bank (NPDB) reports; identify providers that appear in our database and invoke the appropriate process as defined in policy and procedure.
- Facilitate the enrollment of healthcare providers with insurance plans and government healthcare programs, such as Medicare and Medicaid.
- Complete enrollment applications accurately and in a timely manner.
- Coordinate with insurance carriers and government agencies to resolve any enrollment issues or discrepancies.
- Maintain up-to-date knowledge of enrollment requirements and procedures for various payers.
- Ensure compliance with all regulatory requirements related to credentialing and enrollment, including HIPAA regulations and state licensing requirements.
- Stay informed about changes in healthcare regulations and update credentialing and enrollment processes accordingly.
- Develop and maintain policies and procedures to ensure compliance with industry standards.
- Maintain accurate and up-to-date provider information in credentialing and enrollment databases.
- Track expiration dates for licenses, certifications, and other credentials.
- Generate reports and provide analysis related to credentialing and enrollment activities as needed.
- Collaborate with internal teams, including billing, coding, and provider relations, to ensure seamless coordination of credentialing and enrollment processes.
- Serve as a resource to providers and internal staff regarding credentialing and enrollment inquiries.
Who You Are And The Expertise You Bring
- Bachelor's degree in healthcare administration, business administration, or related field (preferred).
- Previous experience in healthcare credentialing and enrollment, preferably in a medical practice, hospital, or healthcare organization.
- Strong understanding of healthcare regulations, including HIPAA, Medicare, and Medicaid.
- Excellent communication skills, both written and verbal.
- Proficiency in using credentialing and enrollment software applications.
- Ability to prioritize tasks and manage multiple projects simultaneously.
- Attention to detail and accuracy in data entry and documentation.
- Ability to work independently and as part of a team in a fast-paced environment.
- Certification in healthcare credentialing (e.g., Certified Provider Credentialing Specialist, CPMS) is a plus.
CAMcare Health Corporation is an Equal Opportunity Employer Benefits
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Professional development assistance
- Retirement plan
- Vision insurance
Job Summary
Full Time
Ambulatory Healthcare Services
$48k-60k (estimate)
06/18/2024
07/16/2024
camcare.net
PAULSBORO, NJ
100 - 200
1978
MARK BRYANT
$10M - $50M
Ambulatory Healthcare Services
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About CAMcare Health Corporation
CAMcare Health Corporation is a Federally Qualified Healthcare Center (FQHC) that has been a trusted name in providing top-quality healthcare services to Camden and Gloucester Counties since 1978. We offer seven convenient locations to provide easier access to the care you need. Patients come to CAMcare because they know they will be treated with great care and compassion by our concerned, highly qualified medical team.
The job skills required for Credentialing and Enrollment Specialist include Billing, Data Entry, Problem Solving, HIPAA, Analysis, Communication Skills, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing and Enrollment Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing and Enrollment Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Credentialing and Enrollment Specialist positions, which can be used as a reference in future career path planning. As a Credentialing and Enrollment Specialist, it can be promoted into senior positions as an Enrollment & Billing Representative III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing and Enrollment Specialist. You can explore the career advancement for a Credentialing and Enrollment Specialist below and select your interested title to get hiring information.
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